All LHRH Agonists Equal for Advanced Prostate Cancer

ROCKVILLE, Md—Patients with advanced prostate cancer treated with luteinizing hormone-releasing hormone (LHRH) agonists have essentially the same survival rate and experience roughly the same side effects regardless of which drug they receive, according to a technology assessment report prepared for the Department of Health and Human Services’ Agency for Health Care Policy and Research (AHCPR).

The report noted that there are substantial differences in costs among the available LHRH agonists.

The report found that combined androgen blockade appears to add little clinical benefit: It only marginally increases survival and causes more severe side effects. Moreover, the report said, there is no evidence to support the idea that certain patients with a good prognosis may benefit from the aggressive treatment.

The study reported insufficient evidence to determine whether starting testosterone suppression as soon as advanced prostate cancer is detected increases a man’s chances of survival. AHCPR, however, noted that waiting until symptoms develop may spare patients years of living with serious treatment side effects, including impotence.

“This report provides the first comprehensive analysis of all the available evidence on first-line treatment of this disease,” said AHCPR administrator John M. Eisenberg, MD. “It will help clarify the difficult choices that face men with advanced prostate cancer, their families, and their physicians.”

The report was prepared by the Blue Cross and Blue Shield Association Technology Evaluation Center, one of the AHCPR-funded Evidence-Based Practice Centers.