Real world data of leuprorelin castration efficacy in patients with prostate cancer: A comprehensive assessment of 1,744 tests.

Abstract

e17000 Background: Androgen deprivation therapy (ADT) has been standing the cornerstone of systemic prostate cancer (PCa) treatment, since Huggins’ findings.Gonadotropin-releasing hormone (GnRH) agonists or antagonists has been used broadly as ADT. However, the majority of studies has focused on Gosserelin, leading to a lack of dedicated investigations into the efficacy of leuprorelin, despite its large use on practice. In this real-world study, we thoroughly analyzed data of testosterone tests in order to comprehensively assess the leuprorelin castration efficacy on the PCa management. Methods: We gathered data from patients diagnosed with PCa who were undergoing treatment with leuprorelin alone or in combination with a novel hormonal agent (NHA) in a single cancer center. The tests spanned a nine-year period from 2014 to 2023 and we assessed the testosterone levels in baseline and after leuprorelin administration, as well as their distribution according to clinicopathologic variables. Results: A total of 1,754 test reports were retrieved from 240 individual pts. The median baseline testosterone level was 317 ng/mL (range: 37-1,136) prior to leuprorelin initiation and the distribution across Gleason grades was: 20 pts had grade 1, 30 pts had grade 2, 61 pts had grade 3, 51 pts had grade 4, and 40 pts had grade 5. Testosterone levels < 50 ng/mL were achieved in 1,730 tests (98.7%) and testosterone levels < 20 ng/mL were found in 1,485 tests (84.7%). A total of 80 pts received combined treatment with leuprorelin + NHA, of which the majority received abiraterone/prednisone (n=52; 65%) or apalutamide (n=11; 13.8%). Following ADT discontinuation, 91 pts presented testosterone levels ≥ 50 ng/mL after a median interval of 258.5 days (range:82-710). Conclusions: In this comprehensive real world database analysis, leuprorelin is able to achieve suitable testosterone suppression levels in nearly the whole study population, such as are seen in others GnRH agonists pivotal trials. Deeper and maintained testosterone suppression levels is predictive of longer time to castration-resistant PCa and real life use of leuprorelin seems to meet this need.