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

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.