Luncheon Symposium 11【Synmosa】

Topic: 

Drug-induced androgen suppression: the importance of galenic formulation for carcinological efficacy.

Abstract:

The treatment of locally advanced and metastatic prostate cancer benefits from the addiction of adenocarcinoma cells to testosterone, and androgen suppression significantly improves the carcinological prognosis of patients.

Androgen suppression can be achieved in various ways, either surgically (pulpectomy) or medically through the administration of GnRH antagonists or agonists. Regarding the latter, leuprorelin is the reference active substance, available in several pharmaceutical forms. These specialties differ in terms of the galenic formulation and the methods of leuprorelin injection.

Maximum androgen suppression with a reduction of testosterone levels below castration values at 0.50 ng/ml is crucial. The improvement in prognosis obtained by achieving deep castration thanks to the addition of abiraterone is proof of this. In this context, the effectiveness of leuprorelin in reducing testicular testosterone levels should not be underestimated and the choice of dosage form is therefore crucial. Not all leuprorelin products are the same and the clinician's choice must consider the specificity of each.

During this state of the art, the rationale for deep androgen suppression will be presented and the advantages of specific galenic leuproreline formulations will be detailed.

Topic:

How to Optimize BPH Treatment: From Evidence to Practice

Abstract:

The α1A-AR selectivity profile of silodosin, as revealed by receptor-binding studies, likely explains the compound's low activity in vascular tissues and its high efficacy in prostate tissue. This selectivity contributes to the drug's low vascular effects and high uroselectivity observed in animal models. These findings have been corroborated by numerous clinical trials, which demonstrate that silodosin has a rapid onset of action and sustained efficacy for treating LUTS due to BPH, all while maintaining an excellent cardiovascular safety profile.

Silodosin is efficacious for the initial management of patients with LUTS. Silodosin has a good cardiovascular safety profile and can be considered an option in PH/LUTS patients with cardiovascular comorbidities.

It seems to be especially beneficial in patients with nocturia alone or presenting with the symptomatic trial nocturia-frequency-incomplete emptying. Patients on PDE5-Is treatment can be safely managed with silodosin. Preliminary results seem to  demonstrate a potential role of silodosin in the treatment of chronic prostatitis/chronic pelvic pain syndrome and to facilitate ureteral stone passage, as well.