The Difference Between an Agonist, an Antiandrogen and an Antagonist in ADT?

Primary, or first line Hormone Therapy (ADT) can involve some different drugs. However, the constant standard includes either a GnRH agonist, such as leuprolide or an antagonist like Firmagon and an antiandrogen like Casodex. 

Warning - A Possible Danger - Xofigo in Combination with Zytiga and Prednisone

The European Medicines Agency (EMA) has recommended halting the use of the Xofigo (radium-223 dichloride) in combination with Zytiga (abiraterone acetate) and prednisone due to a possible increased risk of death and fractures.

Questioning the Wisdom of Combined Androgen Therapy

One of the questions that often come up is how long a man should use an antiandrogen drug like Casodex along with a GnRH agonist like Lupron or Zoladex?  There is no question that an antiandrogen needs to be used before the first dosage of the agonist (Lupron), but should the antiandrogen be stopped or should it be continued along with the agonist (combining an antiandrogen along with the GnRH agonist is often referred to as a combined androgen blockade)?

The Difference Between Agonists, Antiandrogens, and Antagonist in ADT

First line Hormone Therapy (ADT) involves the use of different drugs. These drugs include three different classes of medications with three different modes of action.  They include the GnRH agonists, such as leuprolide, antagonists like Firmagon and the antiandrogens like Casodex. 

Degarelix May Reduce Risk of Cardiovascular Events in Men with Prostate Cancer

Preliminary data that suggests that men with cardiovascular disease being treated for metastatic prostate cancer may experience fewer cardiovascular events when treated with a GnRH antagonist, such as degarelix (Firmagon), compared with a GnRH agonist (Lupron, etc.).

Choosing Docetaxel or Zytiga

Both Taxotere (docetaxel) and Zytiga (abiraterone) are approved for newly diagnosed men with very aggressive prostate cancer and who have not yet had any exposure to hormone therapy (ADT).  

The two approvals lead us to the question, which of these treatment options would be best for you? 

A New Drug Approval- Erleada ™ (apalutamide) For Non-Metastatic Castration-Resistant Prostate Cancer

he FDA approved a new advanced hormone therapy drug (a next-generation androgen receptor inhibitor) for the treatment of men with non-metastatic castration-resistant prostate cancer (NM-CRPC). This drug with the trade name Erleada (aka apalutamide), is the first drug approved in this disease space. 

The FDA Approves Abiraterone Acetate for Some Men with Castrate Sensitive Metastatic Prostate Cancer

The Food and Drug Administration approved the use of abiraterone acetate (Zytiga) with prednisone for men with high-risk, castration-sensitive, chemotherapy-naive metastatic prostate cancer, but there are some hitches and hurdles.

New Standard of Care for Men With Non-Metastatic Castrate Resistant Prostate Cancer 

Two different trials, SPARTAN and PROSPER, are reporting top-line results in the treatment of men with nmCRPC. The full results of these trials will be presented today at the Genitourinary Cancer Symposium in San Francisco where Cancer ABCs is in attendance.

Xofigo Probably Can Be Used More Than Once

Early results from an international, open-label, phase 1/2 trial (NCT01934790) showed that it is possible to successfully re-treat men with the drug known as Xofigo (Ra-223).  The study found that when used a second time, Xofigo was well tolerated and that it provides favorable effects on the cancer’s progression.  

The EU Imposes Restrictions On The Use Of Gadolinium As A Contrast Agent In MRIs

The European Union has recently placed some restrictions on the use of the MRI contrast agent Gadolinium.  There has been concern expressed by recent findings that Gadolinium doesn’t wholly disappear or wash out of a person’s body, but instead stays in a person’s brain.

Confirming The Value of Early Docetaxel in Men With Metastatic Hormone-Sensitive Prostate Cancer

Docetaxel combined with ADT, in men with hormone sensitive prostate cancer, when prescribed as per a study’s protocol led to significantly longer overall survival as well as other positive effects in men with metastatic hormone-sensitive prostate cancer who received only ADT.