Firmagon (Degerelix) - Improved Progression Free Survival?

I've responded in several threads recently - Prato's and I believe at least one other asking for experience with Firmagon. In one of those threads I was asked why I was on Firmagon rather than Lupron and I replied that I was in the control group of a clinical trial and that is what the control arm called for. Also several posters have commented on having been on both Firmagon and Lupron at different times.

This morning my wife forwarded me an update on a friend of hers who is being treated for multple myeloma. He commented about his period of Progression Free Survival (PFS), which prompted me to do a search for PFS relative to prostate cancer, which in turn led to the paper I link below. It discusses PFS of patients treated with Firmagon (a GnRH antagonist) vs patients treated with an LHRH agonist such as Lupron.

The paper concludes:
"Conclusions: Improved PSA-PFS was shown in pts treated with degarelix vs LHRH agonists in metastatic or high risk PCa pts irrespective of region. These results suggest delay of disease progression with initial use of a GnRH antagonist as compared with LHRH agonists across global regions."

This doesn't necessarily mean that improved Progression Free Survival will also lead to improved Overall Survival. But it is another very useful piece of information for me and I assume others here to ponder when choosing courses of treatment.

As I've mentioned elsewhere I've thus far had no SEs from Firmagon, and given the conclusions of this paper, I'm inclined to stay on Firmagon even though it means monthly rather than quarterly or longer intervals between shots.
/academic.oup.com/annonc/article/27/suppl_6/735P/2799473
Jim

Post Edited (Bohemond) : 8/22/2018 9:03:49 AM (GMT-6)

1. thanks Behemond for posting
2. worth noting that the study was funded by Ferring, the maker of Firmagon, and the consultants running the study (it looks like) were paid by Ferring
3. TA, can you tell them to hurry up with that 3 month shot? It would be so great if instead of my last 3 shots, i could get 1 shot being my fourth and last. LOL

Interesting possibility re 3-month Degarelix shots. I see the initial shot is the same at 240 mg and then the shots at each three month interval are 480 mg. I'm wondering if this may risk increased side effects. The standard dosage, which I am on now, and so far with no SEs is an initial shot of 240 mg and then monthly shots of 80 mg. So aside from the initial 240 mg shot my quarterly dosage is 240 mg (three monthly shots of 80 mg each). The dosage used in the Japanese study TA posts above is double that (one 480 mg shot every three months). My concern would be whether the higher dose of Degerelix increase risk of SEs. Also, from my experience, the injection site pain in the days following the initial 240 mg shot is greater than that of the monthly 80 mg. Does a 480 mg shot cause significantly more injection site pain (or not , could be the dosage to pain relationship isn't linear). Does the 480 mg quarterly shot cause more lasting injection site lumps than the monthly 80 mg shots?

Just speculating. If this became available as an option or as standard practice these are things I'd want to know.

Jim

When Luprolide acetate was in testing the patients received their injection daily. Every day. It was to determine if the drug was as effective as surgical castration and later they began adjusting the dose when effectiveness was determined.

Cigafred,
Thanks for the details on your experience. I hadn't heard about the possibility of developing immune reaction, but it kind of makes sense as a potential effect down the road. Hope the switch to Lupron fixes the vision and fainting issue.
Jim