Update: FDA approves Orgovyx, the first oral hormone therapy of its type for treating advanced prostate cancer
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This study is about:
This study is about the recent FDA approval of the oral therapy, Orgovyx (relugolix), to treat advanced prostate cancer.
Why is this study important?
Androgen deprivation therapy (ADT) is a treatment option for advanced prostate cancer (cancer that has spread beyond the prostate). ADT uses drugs to stop the body from making or using testosterone—a hormone that fuels growth of prostate cancer cells.
Orgovyx is an ADT known as a luteinizing hormone releasing hormone (LHRH) antagonist. Medications of this type work by preventing the body from releasing two hormones that stimulate the testicles to make testosterone: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Halting the production of LH and FSH reduces testosterone levels.
For decades, this type of hormone therapy has been administered to patients by injection or implants placed under the skin. The recent FDA-approved drug Orgovyx is a pill taken by mouth. This new option helps some patients eliminate clinical visits that are required to inject or implant prior to ADT treatment.
Approval of Orgovyx was based on data from the international HERO clinical trial, which included 930 men aged 18 or older who had advanced prostate cancer. The men were enrolled in the study from one of 155 medical centers in four continents, including the North America.
During the study, the men were divided into the following treatment groups:
- Orgovyx group: Received Orgovyx as a pill once daily for 48 weeks.
- Leuprolide group: Received leuprolide acetate (a standard androgen deprivation therapy known as a luteinizing hormone releasing hormone agonist) by injection once every three months for 48 weeks.
The goal of the treatment was to achieve and sustain a “castrate level” of testosterone (the level achieved by surgical removal of the testes) between day 29 and week 48.
Study findings showed that:
- The Orgovyx group was more likely to achieve castrate-level testosterone than those in the Leuprolide group.
- 97 percent of men in the Orgovyx group achieved and sustained castrate levels from day 29 to week 48.
- 89 percent of men in Leuprolide group sustained castrate levels from day 29 to week 48.
- Risk for major cardiovascular events, a known side effect of ADT treatment, was 54 percent lower in the Orgovyx group compared with the Leuprolide group.
- Hot flashes
- Joint Pain
- Increased levels of certain liver enzymes
The FDA warns that ADTs, such as Orgovyx, may affect the heart’s electrical properties or cause an imbalance of electrolyte minerals in your body. Regular monitoring of heart functioning during ADT treatment may be recommended by your doctor. In addition, Orgovyx may cause fetal harm or miscarriage. The FDA advises that males with female partners who may become pregnant use effective contraception during treatment and for two weeks after the last dose of Orgovyx.
If you have a diagnosis of advanced prostate cancer and your doctor recommends androgen deprivation therapy, please discuss all options for therapy management. If you are likely to take a daily pill for your prostate cancer, Orgovyx may be an option for you. If you feel as though you are not likely to remember to take a pill every day, standard treatments such as injection by healthcare providers or therapy implants may be a better fit for you.
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This article is relevant for:
Men with advanced prostate cancer
This article is also relevant for:
Prostate cancer survivors
People with metastatic or advanced cancer
Be part of XRAY:
- What are my options for treating prostate cancer?
- Is treatment with Orgovyx an option for me?
- How long will I have to take Orgovyx?
- What are the side effects of taking Orgovyx?
- What are the risks and benefits of standard ADT treatment compared to Orgovyx treatment?
- NCT03565835: Abiraterone With Discontinuation of Gonadotropin-Releasing Hormone Analogues in Metastatic Prostate Cancer The goal of this study is to find out if patients with prostate cancer can discontinue ADT treatment injections while taking the oral medications abiraterone and prednisone to treat prostate cancer. When abiraterone and prednisone are used, ADT injections are usually continued to maintain a low testosterone level in the blood. This study is being done to find out if testosterone in the blood will stay low while abiraterone and prednisone are used without continued hormone injections.
- NCT02949284: Androgen Receptor Antagonist ARN-509 With or Without Abiraterone Acetate, Gonadotropin-Releasing Hormone Analog, and Prednisone in Treating Patients With High-Risk Prostate Cancer Undergoing Surgery This randomized phase II trial studies how well the androgen receptor antagonist ARN-509 works with or without abiraterone acetate, a gonadotropin-releasing hormone agonist, and prednisone, an anti-inflammatory, in treating patients with high-risk prostate cancer who are undergoing surgery.