Modern aspects of agonists luteinizing hormone — releasing hormone in the treatment of prostate cancer (review)

Summary. The basic principle of hormone therapy for prostate cancer (PCa) is the isolation of the tumor from the stimulatory effect of androgens — androgen blockade (deprivation, ablation). Inhibition of androgen function is achieved in different ways: surgical castration; medical castration — inhibition of secretion of pituitary gonadotropins (luteinizing hormone agonists — releasing hormone (LH-RH)) or, on the contrary, an obstacle to show them their activity (antagonists of LH-RH), the blockade of androgen receptor in the tumor tissue (androgens), or a combination thereof. Although today bilateral orchiectomy, which leads to faster, deeper, long-term and irreversible inhibition of testosterone production, is performed rarely, it is considered the standard androgen deprivation is the yardstick with which to compare drugs used for medical castration. A significant number of patients not adequately respond to treatment and suffer from sudden rise in testosterone levels, or do not even reach the promised level of castration. 2–12.5% ​​of patients in the LH-RH agonists do not provide castrate testosterone levels ≤50 ng/dl in 13–46% ≤20 ng/dl in 4–12,5% of patients repeated injections cause a delayed lift. Use of the drug Eligard in three dosage forms increases the therapeutic effect due to the content a double dose of the active substance as compared to other drugs in this class, provides optimum control over the level of testosterone — keeping it below the castration during the period of treatment, the side effects are comparable or even lower than the treatment of other LH-RH agonists, and the route of administration — low-impact.