Factors influencing the choice of androgen deprivation therapy for patients with hormone-sensitive prostate cancer : Results of the ProComD study

• Published in: Urologe. Ausgabe A Vol. 61; no. 2; p. 173
• Main Authors: Lehmann, J, Kluike, C W, Haider, A, Haider, K S, Baumann, S, Flesch, M, Gedamke, M, Kägebein, D
• Format: Journal Article
• Language: German
• Published: Germany 01.02.2022
• Subjects: Androgen Antagonists - adverse effects; Androgens; Gonadotropin-Releasing Hormone; Humans; Male; Prospective Studies; Prostatic Neoplasms - drug therapy; Treatment decision; Treatment options; Comorbidities; GnRH antagonist; Degarelix
• ISSN: 1433-0563
• DOI: 10.1007/s00120-021-01620-7

Androgen deprivation therapy (ADT) with a GnRH agonist or the GnRH antagonist degarelix is a central component in the treatment of prostate cancer (PCa). Little is currently known regarding the decision criteria. Knowledge of these could improve the success of treatment in the future. To identify factors influencing the treatment decision in patients with hormone-sensitive prostate cancer receiving ADT and to determine the incidence of concomitant disease in both treatment groups. The two-arm, prospective, non-interventional study "ProComD" was conducted from September 2014 to June 2019 at 80 study centers in Germany. After the therapy decision was made, patients with hormone-sensitive prostate cancer needing ADT were included in the study. Data were collected during routine visits. Data from 413 patients were evaluated (degarelix N = 268; GnRH agonists N = 145). Key factors influencing the therapy decision for both treatment options included comorbidities (42% of all patients), compliance (64%), and age (81%). The source of information consulted most frequently regarding existing comorbidities was the patient's medical history conducted by the treating urologist themselves (65% in both groups). For patients with pre-existing cardiovascular diseases, the doctor's letter (45.8% degarelix vs. 38.9% GnRH agonists) or the medical history questionnaire (38.9% degarelix vs. 20% GnRH agonists) was additionally taken into account. Comorbidities along with age and compliance are among the key factors influencing the treatment decisions made by urologists.