Adherence to Hormonal Therapies in Prostate Cancer
PURPOSE: Hormonal therapy is the standard of care in prostate cancer (PC) treatment. The approval of the first oral androgen deprivation therapy (ADT), relugolix, to treat PC patients provides an opportunity to review adherence to oral and injectable/implantable hormonal therapies to aid patients and physicians in making informed decisions.
MATERIALS AND METHODS: A PubMed® search for available literature on adherence to hormonal therapy in PC was conducted, including published data on relugolix.
RESULTS: Adherence to oral anti-androgen therapy was above 90% by medication possession ratio (MPR) in several studies worldwide and from 75% to 91% by proportion of days covered (PDC). For injectable/implantable ADT, adherence to treatment ranged from 71% to 95%. In general, 60% and 29% of injections were reported to be delayed by more than 1 week and 2 weeks, respectively, with some patients experiencing testosterone increases (tests above 50 ng/dl). Although real-world data on adherence to relugolix is currently unavailable, PK/PD models demonstrated that, if necessary, treatment interruption up to 7 days would still maintain testosterone suppression levels.
CONCLUSIONS: In general, adherence to hormonal therapy is high in PC. Studies revealed that adherence to injectable ADT dosing schedules is important to maintain castrate levels. PK/PD models showed that relugolix treatment interruption up to 7 days had minimal impact on testosterone suppression levels.
Hafron J, Sangha P, Kung T, Pruett J. Adherence to hormonal therapies in prostate cancer. Urol Pract. 2023 Aug 30:101097UPJ0000000000000445. doi: 10.1097/UPJ.0000000000000445. Epub ahead of print. PMID: 37647139.