Issn Print: 0963–0643

Publication Date: 1998/09/01


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MAB using LHRH agonist Buserelin in combination with short‐term (two weeks) or long‐term (continuous) cyproterone acetate is not superior to standard androgen deprivation in the treatment of advanced prostate cancer

Bob Djavan

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Voogt H, Studer U, Schröder F, Klijn J, de Pauw M, Sylvester RJ, members of the EORTC Genito‐Urinary Tract Cancer Cooperative Group. MAB using LHRH agonist Buserelin in combination with short‐term (two weeks) or long‐term (continuous) cyproterone acetate is not superior to standard androgen deprivation in the treatment of advanced prostate cancer. Eur Urol 1998; 33:152–158.
This study represents the final analysis of the EORTC GU Group trial 30843. For many reasons this study is a valuable contribution to our understanding of MAB and the various aspects of androgen blockade in general. The present study includes three parts (1) LHRH (buserelin) with cyprtoterone acetate (CPA) given for the first 2 weeks only; (2) LHRH with continuous CPA; and (3) orchiectomy. The authors confirmed the results of many preceding studies on different modes of androgen deprivation (Robinson et al., EORTC 30805, 1995 and Navcabil et al. 1987). MAB did not differ from orchiectomy with regards to progression and prolongation of survival. Despite earlier data (EORTC 30853) (Denys L et al. Eur Urol 1998; 33:144–155) showing an advantage for MAB, patients with a good prognosis did not benefit from MAB in this study. This may be due to, as the authors stated correctly, different dosages or types of drugs. The most accurate explanation, however, is probably the differences in patient population with a subsequent impact on efficacy (low number of good prognosis patients). The use of buserelin as a nasal spray is certainly an interesting aspect and was shown to be suitable. Further studies are needed to confirm this.

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