Prostate cancer is the second most common type of cancer among American men. The malignant disease affects the male reproductive system due to uncontrollable growth of cancerous cells in the prostate, a gland located below men’s bladder, near the rectum and around the urethra. Prostate cancer affects both the reproductive and urinary systems, causing symptoms like urinary problems, blood in the urine, erectile dysfunction, pain, and weakness or numbness in the limbs.
Alongside radiation therapy, chemotherapy or surgery, hormone therapy is one of the treatment options for patients with prostate cancer. It is based on the decrease of male hormones androgens, in order to stop the cancer growth and it can be performed through surgical castration, like luteinizing hormone-releasing hormone (LHRH) analogs, or anti-androgen medication like flutamide (Eulexin®), bicalutamide (Casodex®), nilutamide (Nilandron®), Enzalutamide (Xtandi®), Estrogens (female hormones), and Ketoconazole (Nizoral®).
How Goserelin Acetate Works
Goserelin is an implant classified as a gonadotropin-releasing hormone (GnRH) agonist. It is indicated to be used in combination with radiation therapy or flutamide for the treatment of locally confined Stage T2b-T4 (Stage B2-C) carcinoma of the prostate. The growth of the prostate cancer is triggered by male hormones like testosterone. By blocking the function of these hormones and decreasing its levels, goserelin is expected to stop the growth of the tumor and even shrink it.
The compound is available for both men and women, given its effectiveness in the treatment of breast cancer and prostate cancer. “The acetate salt of a synthetic decapeptide analog of luteinizing hormone-releasing hormone (LHRH). Continuous, prolonged administration of goserelin in males results in inhibition of pituitary gonadotropin secretion, leading to a significant decline in testosterone production; in females, prolonged administration results in a decrease in estradiol production,” notes the National Cancer Institute (NCI) Drug Dictionary.
Goserelin Acetate to Treat Prostate Cancer
Goserelin was approved in January 1996 by the US Food and Drug Administration (FDA), and is currently commercialized by AstraZeneca under the brand name Zoladex. The original 3.6 mg formulation of Zoladex was already available since 1989 as a monthly implant. The further approval was based on a study that demonstrated that both a goserolin 10.8 mg or 3.6 mg formulation is as effective as surgical castration through an orchiectomy in controlling the spread of prostate cancer. The findings were faced as a new hope and choice for men between medical treatment and surgery.
The three-month formulation of goserelin is a cylindrical implant with a 1.5 mm diameter with 10.8 mg of the compound. The biodegradable implant is placed through a subcutaneous injection and it slowly dissolves, delivering therapeutic levels of the drug continuously over a period of 12 weeks. This is effective in decreasing the levels of testosterone, and consequently reduces stimulation of hormone-responsive prostate tumors. However, there are also side effects and risks associated with the treatment, being the most commonly reported adverse events hot flashes (64%), general pain (14%), gynecomastia (8%), pelvic pain (6%), and bone pain (6%).
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