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Drug Information
    Posted: 12/30/2008
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Prostate Cancer Home Page 1
NCI's gateway for information about prostate cancer.

Drug Information Summaries 2
NCI's drug information summaries provide consumer-friendly information about certain drugs that are approved by the U.S. Food and Drug Administration (FDA) to treat cancer or conditions related to cancer.
FDA Approval for Degarelix

  • Approved for advanced prostate cancer

Full prescribing information 3 is available, including clinical trial information, safety, dosing, drug-drug interactions and contraindications.

On December 24, 2008, the U. S. Food and Drug Administration (FDA) approved degarelix for injection (Ferring Pharmaceuticals Inc.), a new gonadotropin releasing hormone (GnRH) receptor antagonist, for the treatment of patients with advanced prostate cancer. This indication is based on degarelix's effectiveness in attaining and maintaining serum testosterone suppression to medical castration levels during 12 months of treatment in an open-label, randomized, multicenter, parallel-group study.

A total of 620 patients were randomly selected to receive one of two degarelix dosing regimens or leuprolide for one year: degarelix at a starting dose of 240 mg followed by monthly doses of 160 mg subcutaneously, degarelix at a starting dose of 240 mg followed by monthly doses of 80 mg subcutaneously, or monthly doses of leuprolide 7.5 mg intramuscularly. The primary objective was to demonstrate that degarelix is effective in achieving and maintaining testosterone suppression to castration levels (≤ 50 ng/dL) during 12 months of treatment. The medical castration rates were:

  • 98.3 percent (95% CI: 94.8%; 99.4%) in the degarelix 240/160 mg arm
  • 97.2 percent (95% CI: 93.5%; 98.8%) in degarelix 240/80 mg arm
  • 96.4 percent (95% CI: 92.5%; 98.2%) in the leuprolide 7.5 mg arm

The key secondary analyses showed that no testosterone surges were observed in the degarelix arms and that 96 percent of patients attained medical castration 3 days after the first degarelix dose compared to no patients receiving leuprolide.

The most commonly observed adverse reactions (frequency of >10 percent) in either degarelix arm included injection site reactions (e.g., pain, erythema, swelling or induration), hot flashes, weight increase, and increases in transaminases and gamma-glutamyltransferase. The majority of the adverse reactions were grade 1/2 in severity; grade 3/4 adverse reactions were uncommon. The injection site reactions were transient, with frequencies of 35-44 percent in the degarelix arms compared to a frequency of <1 percent in the leuprolide arm. Hepatic laboratory abnormalities were generally reversible, with grade 3 abnormalities in less than 1 percent of patients. There were no important differences in adverse reactions between the two degarelix arms, except for fewer injection site reactions in the 240/80 mg arm.

The recommended dosing regimen is a starting dose of 240 mg given as two subcutaneous injections of 120 mg each followed by monthly maintenance doses of 80 mg given as a single subcutaneous injection.

This summary was provided by Richard Pazdur, M.D., director of the FDA's Division of Oncology Drug Products, or Patricia Keegan, M.D., director of the FDA's Division of Clinical Trials Design and Analysis.

The FDA is the division of the U.S. Department of Health and Human Services charged with ensuring the safety and effectiveness of new drugs and other products. (See "Understanding the Approval Process for New Cancer Treatments 4.") The FDA's mission is to promote and protect the public health by helping safe and effective products to reach the market in a timely way, and monitoring products for continued safety after they are in use.

For further information related to oncology drug approvals, regulatory information and other oncology resources, please refer to the FDA's Oncology Tools 5 Web site.


Glossary Terms

antagonist
In medicine, a substance that stops the action or effect of another substance. For example, a drug that blocks the stimulating effect of estrogen on a tumor cell is called an estrogen receptor antagonist.
erythema (ER-ih-THEE-muh)
Redness of the skin.
GnRH
A hormone made by the hypothalamus (part of the brain). GnRH causes the pituitary gland to make luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are involved in reproduction. Also called gonadotropin-releasing hormone.
hepatic (hih-PA-tik)
Refers to the liver.
hormone (HOR-mone)
One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
hot flash
A sudden, temporary onset of body warmth, flushing, and sweating (often associated with menopause).
leuprolide (LOO-pro-lide)
The active ingredient in a drug used to treat symptoms of advanced prostate cancer. It is also used to treat early puberty in children and certain gynecologic conditions. It is being studied in the treatment of other conditions and types of cancer. Leuprolide blocks the body from making testosterone (a male hormone) and estradiol (a female hormone). It may stop the growth of prostate cancer cells that need testosterone to grow. It is a type of gonadotropin-releasing hormone analog.
medical castration
Refers to the use of drugs to suppress the function of the ovaries or testicles.
prostate cancer (PROS-tayt KAN-ser)
Cancer that forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men.
receptor (reh-SEP-ter)
A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell.
testosterone (tes-TOS-teh-RONE)
A hormone made mainly in the testes (part of the male reproductive system). It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Testosterone may also be made in the laboratory and is used to treat certain medical conditions.


Table of Links

1http://www.cancer.gov/cancertopics/types/prostate
2http://www.cancer.gov/cancertopics/druginfo/alphalist
3http://www.fda.gov/cder/foi/label/2008/022201lbl.pdf
4http://www.cancer.gov/clinicaltrials/learning/approval-process-for-cancer-drugs
5http://www.fda.gov/cder/cancer