Abstract
Triptorelin is a synthetic analog of gonadotropin-releasing hormone (GnRH; also known as luteinizing hormone-releasing hormone [LHRH]), which has enhanced receptor affinity, extended half-life and increased bioactivity. Triptorelin initially stimulates the pituitary gland, increasing serum luteinizing hormone and testosterone levels; however, after 3–4 weeks, the pituitary becomes refractory due to receptor desensitization and/or down-regulation, resulting in castration levels of testosterone in men and postmenopausal estradiol levels in women.
Pharmacologic equivalence studies have shown that triptorelin, buserelin and goserelin are equally effective in down-regulating the pituitary-gonadal axis, and the new 3- and 1-month depot formulations of triptorelin have equal efficacy. In men with locally advanced or metastatic prostate cancer, administration of triptorelin leads to subjective improvement in lower urinary tract symptoms and pain, as well as objective responses such as decreased serum levels of acid and alkaline phosphatase and prostate-specific antigen, decreased prostate volume, and regression of skeletal metastases.
Randomized clinical trials comparing triptorelin with bilateral orchidectomy have shown no significant differences in clinical response, survival or side effects. The time to subjective response was shorter in patients treated with orchidectomy, but there was a trend towards reduced psychologic morbidity in those treated with triptorelin. In randomized clinical trials comparing triptorelin with leuprolide (leuprorelin), two studies concluded that triptorelin induced a more rapid decrease in testosterone levels, although both drugs had similar clinical efficacy, whereas a third study concluded that triptorelin reduced testosterone levels less rapidly than, but maintained castration levels of testosterone as effectively as, leuprolide. The 9-month survival rate was significantly higher for triptorelin (97% vs 90.5% for leuprorelin).
Neoadjuvant triptorelin treatment in localized prostate cancer prior to radical prostatectomy may reduce the incidence of positive surgical margins, but no survival advantage has been demonstrated. Neoadjuvant treatment before radiotherapy, by reducing prostatic volume, may decrease radiation-related complications, and may increase survival in a subset of patients with a Gleason score of 2–6.
The most common adverse effects of triptorelin and GnRH agonists in general, are hot flushes, loss of libido, and impotence. The initial increase in serum testosterone levels — the ‘flare’ phenomenon — may lead to exacerbation of bone pain, paraplegia and (rarely) death in patients with a large tumor burden. Androgen deprivation leads to a reduction in bone mineral density of 3–5% per year, but it remains to be proven that this significantly increases the clinical fracture risk in patients with prostate cancer.
In conclusion, the clinical efficacy and tolerability of triptorelin in the treatment of prostate cancer are similar to that of surgical castration and leuprolide.
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References
Schlegel PN, Hardy M. Male reproductive physiology. In: Walsh PC, Retik AB, Darracot Vaughan E, et al., editors. Campbell’s urology. 8thed. Philadelphia (PA): Saunders, 2002: 1437–1473
Schally AV, Kastin AJ, Arimura A. Hypothalamic follicle-stimulating hormone (FSH) and luteinizing hormone (LH)-regulating hormone: structure, physiology, and clinical studies. Fertil Steril 1971Nov; 22(11): 703–21
Schröder FH. Hormone therapy of prostate cancer. In: Walsh PC, Retik AB, Darracott Vaughan E, et al., editors. Campbell’s urology. 8thed. Philadelphia (PA): Saunders, 2002: 3182–3208
Cockshott ID. Clinical pharmacokinetics of goserelin. Clin Pharmacokinet 2000; 39(1): 27–48
Asch RH, Rojas FJ, Tice TR, et al. Studies of a controlled-release microcapsule formulation of an LH-RH agonist (D-Trp-6-LH-RH) in the rhesus monkey menstrual cycle. Int J Fertil 1985; 30(2): 19–26
Csernus VJ, Szende B, Schally AV. Release of peptides from sustained delivery systems (microcapsules and microparticles) in vivo: a histological and immunohistochemical study. Int J Pept Protein Res 1990Jun; 35(6): 557–65
Chien YW, Lin S. Optimisation of treatment by applying programmable rate-controlled drug delivery technology. Clin Pharmacokinet 2002; 41(15): 1267–99
Progent F, Taverna M, LePotier I, et al. A study of the binding between polymers and peptides, using affinity capillary electrophoresis, applied to polymeric drug delivery systems. Electrophoresis 2002Mar; 23(6): 938–44
Nicoli S, Santi P, Couvreur P, et al. Design of triptorelin loaded nanospheres for transdermal iontophoretic administration. Int J Pharm 2001Feb 19; 214(1–2): 31–5
Nicoli S, Rimondi S, Colombo P, et al. Physical and chemical enhancement of transdermal delivery of triptorelin. Pharm Res 2001Nov; 18(11): 1634–7
Muller FO, Terblanche J, Schall R, et al. Pharmacokinetics of triptorelin after intravenous bolus administration in healthy males and in males with renal or hepatic insufficiency. Br J Clin Pharmacol 1997Oct; 44(4): 335–41
Schally AV, Coy DH, Arimura A. LH-RH agonists and antagonists. Int J Gynaecol Obstet 1980; 18(5): 318–24
Barron JL, Millar RP, Searle D. Metabolic clearance and plasma half-disappearance time of D-TRP6 and exogenous luteinizing hormone-releasing hormone. J Clin Endocrinol Metab 1982Jun; 54(6): 1169–73
Millar RP, King JA. Synthesis and biological activity of [D-Trp6] chicken luteinizing hormone-releasing hormone. Peptides 1983; ai]4_(4): 425–9
Ban E, Crumeyrolle-Arias M, Latouche J, et al. GnRH receptors in rat brain, pituitary and testis; modulation following surgical and gonadotropin-releasing hormone agonist-induced castration. Mol Cell Endocrinol 1990Mar 26; 70(1): 99–107
Liebow C, Lee MT, Kamer AR, et al. Regulation of luteinizing hormone-releasing hormone receptor binding by heterologous and autologous receptor-stimulated tyrosine phosphorylation. Proc Natl Acad Sci U S A 1991Mar 15; 88(6): 2244–8
Lerrant Y, Kottler ML, Bergametti F, et al. Expression of gonadotropin-releasing hormone (GnRH) receptor gene is altered by GnRH agonist desensitization in a manner similar to that of gonadotropin beta-subunit genes in normal and castrated rat pituitary. Endocrinology 1995Jul; 136(7): 2803–8
Rodriguez T, Bordiu E, Rubio JA, et al. Effect of pulse frequency and amplitude of D-Trp6-luteinizing hormone-releasing hormone on the pulsatile secretion of prolactin and LH. J Endocrinol Invest 1993Sep; 16(8): 601–7
Lahlou N, Roger M, Chaussain JL, et al. Gonadotropin and alpha-subunit secretion during long term pituitary suppression by D-Trp6-luteinizing hormone-releasing hormone microcapsules as treatment of precocious puberty. J Clin Endocrinol Metab 1987Nov; 65(5): 946–53
Simard J, Labrie C, Hubert JF, et al. Modulation by sex steroids and [D-Trp6, Des-Gly-NH2 (10)] luteinizing hormone (LH)-releasing hormone ethylamide of alpha-subunit and LH beta messenger ribonucleic acid levels in the rat anterior pituitary gland. Mol Endocrinol 1988Sep; 2(9): 775–84
Couzinet B, Lahlou N, Thomas G, et al. Effects of gonadotrophin releasing hormone antagonist and agonist on the pulsatile release of gonadotrophins and alpha-subunit in postmenopausal women. Clin Endocrinol(Oxf) 1991Jun; 34(6): 477–83
Lindner C, Lichtenberg V, Braendle W. Gonadotropin and free alpha-subunit secretion in patients during GnRH-agonist treatment. Horm Metab Res 1991Nov; 23(11): 553–8
Wide L, Albertsson-Wikland K, Phillips DJ. More basic isoforms of serum gonadotropins during gonadotropin-releasing hormone agonist therapy in pubertal children. J Clin Endocrinol Metab 1996Jan; 81(1): 216–21
Lahlou N, Carel JC, Chaussain JL, et al. Pharmacokinetics and pharmacodynamics of GnRH agonists: clinical implications in pediatrics. J Pediatr Endocrinol Metab 2000Jul; 13Suppl.1: 723–37
Ben-Menahem D, Shraga-Levine Z, Limor R, et al. Arachidonic acid and lipoxygenase products stimulate gonadotropin alpha-subunit mRNA levels in pituitary alpha T3-1 cell line: role in gonadotropin releasing hormone action. Biochemistry 1994Nov 1; 33(43): 12795–9
Hierowski MT, Waring AJ, Schally AV. Synthesis and degradation of cyclic nucleotides in the pituitary gland, ovary and testis of rats treated with D-Trp6-luteinizing hormone-releasing hormone. Biochim Biophys Acta 1981Jul; 675(2): 232–8
Garrel G, Lerrant Y, Siriostis C, et al. Evidence that gonadotropin-releasing hormone stimulates gene expression and levels of active nitric oxide synthase type I in pituitary gonadotrophs, a process altered by desensitization and, indirectly, by gonadal steroids. Endocrinology 1998Apr; 139(4): 2163–70
Tadir Y, Glezerman M, Eshkol A, et al. Comparison of pituitary response to regular GnRH, analogue (D-TRP6) and placebo. Andrologia 1980; 12(5): 455–60
Heiman ML, Nekola MV, Murphy WA, et al. An extremely sensitive in vitro model for elucidating structure-activity relationships of growth hormone-releasing factor analogs. Endocrinology 1985Jan; 116(1): 410–5
Laron Z, Dickerman Z, Ben Zeev Z, et al. Long-term effect of D-Trp6-luteinizing hormone-releasing hormone on testicular size and luteinizing hormone, follicle-stimulating hormone, and testosterone levels in hypothalamic hypogonadotropic males. Fertil Steril 1981Mar; 35(3): 328–31
Sundaram K, Connell KG, Bardin CW, et al. Inhibition of pituitary-testicular function with [D-Trp6] luteinizing hormone-releasing hormone in rhesus monkeys. Endocrinology 1982Apr; 110(4): 1308–14
Evans RM, Doelle GC, Lindner J, et al. A luteinizing hormone-releasing hormone agonist decreases biological activity and modifies chromatographic behavior of luteinizing hormone in man. J Clin Invest 1984Jan; 73(1): 262–6
Bokser L, Zalatnai A, Schally AV. Inhibition of pituitary-gonadal axis in mice by long-term administration of D-Trp-6-LHRH microcapsules. J Reprod Fertil 1989Mar; 85(2): 569–74
Redding TW, Schally AV. Inhibition of the pituitary-gonadal axis in nude male mice by continuous administration of LHRH agonists and antagonists. J Endocrinol 1990Aug; 126(2): 309–15
Tolis G, Mehta A, Comaru-Schally AM, et al. Suppression of androgen production by D-tryptophan-6-luteinizing hormone-releasing hormone in man. J Clin Invest 1981Sep; 68(3): 819–22
Shadmi AL, Lunenfeld B, Bahari C, et al. Abolishment of the positive feedback mechanism: a criterion for temporary medical hypophysectomy by LH-RH agonist. Gynecol Endocrinol 1987Mar; 1(1): 1–11
Redding TW, Schally AV. Inhibition of prostate tumor growth in two rat models by chronic administration of D-Trp6 analogue of luteinizing hormone-releasing hormone. Proc Natl Acad Sci U S A 1981Oct; 78(10): 6509–12
Redding TW, Schally AV, Tice TR, et al. Long-acting delivery systems for peptides: inhibition of rat prostate tumors by controlled release of [D-Trp6] luteinizing hormone-releasing hormone from injectable microcapsules. Proc Natl Acad Sci U S A 1984Sep; 81(18): 5845–8
Pinski J, Reile H, Halmos G, et al. Inhibitory effects of analogs of luteinizing hormone-releasing hormone on the growth of the androgen-independent Dunning R-3327-AT-1 rat prostate cancer. Int J Cancer 1994Oct 1; 59(1): 51–5
Jungwirth A, Pinski J, Galvan G, et al. Inhibition of growth of androgen-independent DU-145 prostate cancer in vivo by luteinising hormone-releasing hormone antagonist Cetrorelix and bombesin antagonists RC-3940-II and RC-3950-II. Eur J Cancer 1997Jun; 33(7): 1141–8
Lamharzi N, Halmos G, Jungwirth A, et al. Decrease in the level and mRNA expression of LH-RH and EGF receptors after treatment with LH-RH antagonist cetrorelix in DU-145 prostate tumor xenografts in nude mice. Int J Oncol 1998Sep; 13(3): 429–35
Ravenna L, Salvatori L, Morrone S, et al. Effects of triptorelin, a gonadotropin-releasing hormone agonist, on the human prostatic cell lines PC3 and LNCaP. J Androl 2000; 21(4): 549–57
Emons G, Muller V, Ortmann O, et al. Effects of LHRH-analogues on mitogenic signal transduction in cancer cells. J Steroid Biochem Mol Biol 1998Apr; 65(1–6): 199–206
Ron IG, Wigler N, Merimsky O, et al. A phase II trial of D-Trp-6-LHRH (decapeptyl) in pretreated patients with advanced epithelial ovarian cancer. Cancer Invest 1995; 13(3): 272–5
Falkson CI, Falkson HC, Falkson G, et al. Cisplatin versus cisplatin plus D-Trp-6-LHRH in the treatment of ovarian cancer: a pilot trial to investigate the effect of the addition of a GnRH analogue to cisplatin. Oncology 1996; 53(4): 313–7
Emons G, Ortmann O, Teichert HM, et al. Luteinizing hormone-releasing hormone agonist triptorelin in combination with cytotoxic chemotherapy in patients with advanced ovarian carcinoma: a prospective double blind randomized trial. Decapeptyl Ovarian Cancer Study Group. Cancer 1996Oct 1; 78(7): 1452–60
Duffaud F, van derBurg ME, Namer M, et al. D-TRP-6-LHRH (triptorelin) is not effective in ovarian carcinoma: an EORTC Gynaecological Cancer Co-operative Group Study. Anticancer Drugs 2001Feb; 12(2): 159–62
Lhomme C, Vennin P, Callet N, et al. A multicenter phase II study with triptorelin (sustained-release LHRH agonist) in advanced or recurrent endometrial carcinoma: a French anticancer federation study. Gynecol Oncol 1999Nov; 75(2): 187–93
Manesis EK, Giannoulis G, Zoumboulis P, et al. Treatment of hepatocellular carcinoma with combined suppression and inhibition of sex hormones: a randomized, controlled trial. Hepatology 1995Jun; 21(6): 1535–42
Grimaldi C, Bleiberg H, Gay F, et al. Evaluation of antiandrogen therapy in unresectable hepatocellular carcinoma: results of a European Organization for Research and Treatment of Cancer multicentric double-blind trial. J Clin Oncol 1998Feb; 16(2): 411–7
Gonzalez-Barcena D, Ibarra-Olmos MA, Garcia-Carrasco F, et al. Influence of D-Trp-6-LH-RH on the survival time in patients with advanced pancreatic cancer. Biomed Pharmacother 1989; 43(4): 313–7
Francois E, Lagrange JL, Benchimol D, et al. Advanced cancer of the exocrine pancreas treated by a long-acting luteinising hormone releasing hormone (LH-RH) analogue, triptorelin: phase II study [in French]. Ann Chir 1991; 45(10): 909–11
Partsch CJ, Heger S, Sippell WG. Treatment of central precocious puberty: lessons from a 15 years prospective trial. German Decapeptyl Study Group. J Pediatr Endocrinol Metab 2000Jul; 13 Suppl.1: 747–58
Partsch CJ, Sippell WG. Treatment of central precocious puberty. Best Pract Res Clin Endocrinol Metab 2002Mar; 16(1): 165–89
Ozkan B, Topaloglu AK, Bilginturan N. A practical GnRH analogue (triptorelin) stimulation test to distinguish constitutional delay of puberty from hypogonadotropic hypogonadism in prepubertal boys. Turk J Pediatr 2001; 43(2): 114–7
Neskovic-Konstantinovic ZB, Vuletic LB, Nikolic-Stanojevic LI, et al. Therapeutic and endocrine effects of Decapeptyl, synthetic LH-RH agonistic analogue in premenopausal women with metastatic breast cancer: a pilot phase II study. Oncology 1994; 51(1): 95–101
Garcia-Giralt E, Beuzeboc P, Dieras V, et al. Phase II trial of decapeptyl (D-TRP-6), a potent luteinizing hormone-releasing hormone analogue in untreated advanced breast cancer. Am J Clin Oncol 1996Oct; 19(5): 455–8
Celio L, Martinetti A, Ferrari L, et al. Premenopausal breast cancer patients treated with a gonadotropin-releasing hormone analog alone or in combination with an aromatase inhibitor: a comparative endocrine study. Anticancer Res 1999; 19(3B): 2261–8
Lissoni P, Vaghi M, Villa S, et al. Antiprolactinemic approach in the treatment of metastatic breast cancer: a phase II study of polyneuroendocrine therapy with LHRH-analogue, tamoxifen and the long-acting antiprolactinemic drug cabergoline. Anticancer Res 2003; 23(1B): 733–6
Monsonego J, Destable MD, De Saint Florent G, et al. Fibrocystic disease of the breast in premenopausal women: histohormonal correlation and response to luteinizing hormone releasing hormone analog treatment. Am J Obstet Gynecol 1991May; 164(5 Pt 1): 1181–9
Gianaroli L, Ferraretti AP, Feliciani E, et al. Prospective randomized study of D-Trp6-LHRH versus buserelin in long desensitization protocols for medically assisted conception cycles. Hum Reprod 1994Feb; ai]9_(2): 220–5
Janssens RM, Lambalk CB, Vermeiden JP, et al. Dose-finding study of triptorelin acetate for prevention of a premature LH surge in IVF: a prospective, randomized, double-blind, placebo-controlled study. Hum Reprod 2000Nov; 15(11): 233–40
Dal Prato L, Borini A, Trevisi MR, et al. Effect of reduced dose of triptorelin at the start of ovarian stimulation on the outcome of IVF: a randomized study. Hum Reprod 2001Jul; 16(7): 1409–14
Tay CC. Use of gonadotrophin-releasing hormone agonists to trigger ovulation. Hum Fertil (Camb) 2002Feb; 5(1): G35–7
Al-Inany H, Aboulghar M. GnRH antagonist in assisted reproduction: a Cochrane review. Hum Reprod 2002Apr; 17(4): 874–85
Romer T, Schwesinger G. Hormonal inhibition of endometrium for transcervical endometrial ablation: a prospective study with a 2-year follow-up. Eur J Obstet Gynecol Reprod Biol 1997Aug; 74(2): 201–3
Sowter MC, Singla AA, Lethaby A. Pre-operative endometrial thinning agents before hysteroscopic surgery for heavy menstrual bleeding. Cochrane Database Syst Rev 2000; (2): CD001124. Update in: Cochrane Database Syst Rev 2002; (3): CD001124
Grimbizis G, Tsalikis T, Tzioufa V, et al. Regression of endometrial hyperplasia after treatment with the gonadotrophin-releasing hormone analogue triptorelin: a prospective study. Hum Reprod 1999Feb; 14(2): 479–84
Perez-Medina T, Bajo J, Folgueira G, et al. Atypical endometrial hyperplasia treatment with progestogens and gonadotropin-releasing hormone analogues: long-term follow-up. Gynecol Oncol 1999May; 73(2): 299–304
Abramovici H, Dirnfeld M, Auslander R, et al. Pregnancies following treatment by GnRH-a (Decapeptyl) and myomectomy in infertile women with uterine leiomyomata. Int J Fertil Menopausal Stud 1994; 39(3): 150–5
Kuhlmann M, Gartner A, Schindler EM, et al. Uterine leiomyomata and sterility: therapy with gonadotropin-releasing hormone agonists and leiomyomectomy. Gynecol Endocrinol 1997Jun; 11(3): 169–74
Vercellini P, Crosignani PG, Mangioni C, et al. Treatment with a gonadotrophin releasing hormone agonist before hysterectomy for leiomyomas: results of a multicentre, randomised controlled trial. Br J Obstet Gynaecol 1998Nov; 105(11): 1148–54
Bergqvist A, Bergh T, Hogstrom L, et al. Effects of triptorelin versus placebo on the symptoms of endometriosis. Fertil Steril 1998Apr; ai]69_(4): 702–8
Cheung TK, Lo KW, Lam CW, et al. A crossover study of triptorelin and leuprorelin acetate. Fertil Steril 2000Aug; 74(2): 299–305
Cosson M, Querleu D, Donnez J, et al. Dienogest is as effective as triptorelin in the treatment of endometriosis after laparoscopic surgery: results of a prospective, multicenter, randomized study. Fertil Steril 2002Apr; 77(4): 684–92
Carmina E, Lobo RA. Gonadotrophin-releasing hormone agonist therapy for hirsutism is as effective as high dose cyproterone acetate but results in a longer remission. Hum Reprod 1997Apr; 12(4): 663–6
DeLeo V, Fulghesu AM, la Marca A, et al. Hormonal and clinical effects of GnRH agonist alone, or in combination with a combined oral contraceptive or flutamide in women with severe hirsutism. Gynecol Endocrinol 2000Dec; 14(6): 411–6
Rossi R, Tauchmanova L, Luciano A, et al. Functional hyperandrogenism detected by corticotropin and GnRH-analogue stimulation tests in women affected by apparently idiopathic hirsutism. J Endocrinol Invest 2001; 24(7): 491–8
DeBlock CE, Leeuw IH, Gaal LF. Premenstrual attacks of acute intermittent porphyria: hormonal and metabolic aspects: a case report. Eur J Endocrinol 1999Jul; 141(1): 50–4
Castelo-Branco C, Vicente JJ, Vanrell JA. Use of gonadotropin-releasing hormone analog with tibolone to prevent cyclic attacks of acute intermittent porphyria. Metabolism 2001Sep; 50(9): 995–6
Bauer J, Wildt L, Flugel D, et al. The effect of a synthetic GnRH analogue on catamenial epilepsy: a study in ten patients. J Neurol 1992May; 239(5): 284–6
Blumenfeld Z, Bentur L, Yoffe N, et al. Menstrual asthma: use of a gonadotropin-releasing hormone analogue for the treatment of cyclic aggravation of bronchial asthma. Fertil Steril 1994Jul; 62(1): 197–200
Lolis D, Adonakis G, Kontostolis E, et al. Successful conservative treatment of catamenial pneumothorax with GnRH agonist. Arch Gynecol Obstet 1995; 256(3): 163–6
Creatsas G, Hassan E, Deligeoroglou E, et al. Treatment of polycystic ovarian disease during adolescence with ethinylestradiol/cyproterone acetate versus a D-Tr-6-LHRH analog. Int J Gynaecol Obstet 1993Aug; 42(2): 147–53
Goni M, Markussis V, Tolis G. Efficacy of chronic therapy with the gonadotrophin releasing hormone agonist decapeptyl in patients with polycystic ovary syndrome. Hum Reprod 1994Jun; 9(6): 1048–52
Buyalos RP, Lee CT. Polycystic ovary syndrome: pathophysiology and outcome with in vitro fertilization. Fertil Steril 1996Jan; 65(1): 1–10
Blumenfeld Z. Ovarian rescue/protection from chemotherapeutic agents. J Soc Gynecol Investig 2001; 8(1 Suppl. Proceedings): S60–4
Rosier A, Witztum E. Treatment of men with paraphilia with a long-acting analogue of gonadotropin-releasing hormone. N Engl J Med 1998Feb 12; 338(7): 416–22
Lepor H, Lowe FC. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: ai]Walsh_PC, Retik AB, Darracott Vaughan E, et al., editors. Campbell’s urology. 8thed. Philadelphia (PA): Saunders, 2002: 1358–1377
Matzkin H, Chen J, Lewysohn O, et al. Treatment of benign prostatic hypertrophy by a long-acting gonadotropin-releasing hormone analogue: 1-year experience. J Urol 1991Feb; 145(2): 309–12
Zarate A, Fonseca ME, Mason M, et al. Gonadotropin-secreting pituitary adenoma with concomitant hypersecretion of testosterone and elevated sperm count: treatment with LRH agonist. Acta Endocrinol (Copenh) 1986Sep; 113(1): 29–34
Sassolas G, Lejeune H, Trouillas J, et al. Gonadotropin-releasing hormone agonists are unsuccessful in reducing tumoral gonadotropin secretion in two patients with gonadotropin-secreting pituitary adenomas. J Clin Endocrinol Metab 1988Jul; 67(1): 180–5
Rubio MA, Cabranes JA, Schally AV, et al. Prolactin-lowering effect of luteinizing hormone-releasing hormone agonist administration in prolactinoma patients. J Clin Endocrinol Metab 1989Aug; 69(2): 444–7
Golan A, Bukovsky I, Weinraub Z, et al. The effect of chronic gonadotropin-releasing hormone analog (D-Trp-6) treatment on elevated and normal serum prolactin levels. Fertil Steril 1989Mar; 51(3): 532–4
Boccardo F, Decensi A, Guarneri D, et al. Long-term results with a long-acting formulation of D-TRP-6 LH-RH in patients with prostate cancer: an Italian prostatic cancer project (P.O.N.CA.P.) study. Prostate 1987; 11(3): 243–55
Boccardo F, Decensi A, Guarneri D, et al. Long-acting (depot) D-TRP-6 LH-RH (Decapeptyl) in prostate cancer: an Italian multicentric trial. Am J Clin Oncol 1988; 11 Suppl. 2: S129–31
Bouchot O, Soret JY, Jacqmin D, et al. Three-month sustained-release form of triptorelin in patients with advanced prostatic adenocarcinoma: results of an open pharmacodynamic and pharmacokinetic multicenter study. Horm Res 1998; 50(2): 89–93
Fretin J, Demerle F, Jardin A. Induction and maintenance of castration by an LHRH analogue: D-Trp6 LHRH or Decapeptyl. Prog Clin Biol Res 1987; 243A: 207–20
Giuliani L, Barreca T, Giberti C, et al. Treatment of prostatic cancer with a depot form of a luteinizing hormone-releasing hormone analogue. Eur Urol 1986; 12(6): 390–4
Gonzalez-Barcena D, Perez-Sanchez P, Ureta-Sanchez S, et al. Treatment of advanced prostatic carcinoma with D-Trp-6-LH-RH. Prostate 1985; 7(1): 21–30
Gonzalez-Barcena D, Perez-Sanchez P, Berea-Dominguez H, et al. Persistent blockade of the pituitary-gonadal axis in patients with prostatic carcinoma during chronic administration of D-Trp-6-LH-RH. Prostate 1986; 9(2): 207–15
Gonzalez-Barcena D, Perez-Sanchez PL, Graef A, et al. Inhibition of the pituitary-gonadal axis by a single intramuscular administration of D-Trp-6-LH-RH (decapeptyl) in a sustained-release formulation in patients with prostatic carcinoma. Prostate 1989; 14(4): 291-300
Klippel KF, Winkler CJ, Jocham D, et al. Effectiveness and tolerance of 1 dosage forms (subcutaneous and intramuscular) of decapeptyl depot in patients with advanced prostate carcinoma [in German]. Urologe A 1999May; 38(3): 270–5
Marcellino LR, Campanella A, Bandini M. Contribution to studies on the treatment of cancer of the prostate with D-Trp6-LH-RH [in French]. Biomed Pharmacother 1987; 41(9–10): 468–72
Mathe G, Vo Van ML, Duchier J, et al. An oriented phase-II trial of D-Trp6-LH-RH in patients with prostatic carcinoma. Med Oncol Tumor Pharmacother 1984; 1(2): 119–22
Mathe G, Schally AV, Vo Van ML, et al. An analog of gonadoliberin in the treatment of prostatic carcinoma [in French]. Presse Med 1984Jun 2; 13(23): 1443–5
Seppelt U, Bertermann H, Saerbeck C. Decapeptyl (D-Trp6-LH-RH) in the therapy of prostatic cancer with reference to the intramuscular administration of a depot preparation [in German]. Urologe A 1986Sep; 25(5): 298–301
Steg A, Chiche R, Boccon-Gibod L, et al. Treatment of prostatic cancer with an LH-RH agonist: the D Trp6 LH-RH: preliminary results in 30 cases [in French]. Ann Urol (Paris) 1984Dec; 18(6): 388–92
Steg A, Chiche R, Boccon-Gibod L, et al. Treatment of advanced prostatic cancer with a gonadorelin agonist, dTrp6 LHRH. 41 cases [in French]. Presse Med 1985Nov 23; 14(40): 2045–8
Teillac P, Heyns CF, Kaisary AV, et al. Pharmacodynamic equivalence of a decapeptyl 3-month SR formulation with the 28-day SR formulation in patients with advanced prostate cancer. Horm Res 2004; 62(5): 252–8
Tolis G, Ackman D, Stellos A, et al. Tumor growth inhibition in patients with prostatic carcinoma treated with luteinizing hormone-releasing hormone agonists. Proc Natl Acad Sci U S A 1982Mar; 79(5): 1658–62
Roger M, Duchier J, Lahlou N, et al. Treatment of prostatic cancers by periodic administration of a delayed-release preparation of D-Trp (6)-LHRH [in French]. Ann Urol (Paris) 1986; 20(2): 109–12
Mathe G, Misset JL, Vovan ML, et al. Advanced cancer of the prostate: treatment with an LH-RH agonist, D-Trp-6-LH-RH [in French]. Bull Cancer 1986; 73(1): 31–5
Labrie F, Dupont A, Belanger A, et al. Flutamide eliminates the risk of disease flare in prostatic cancer patients treated with a luteinizing hormone-releasing hormone agonist. J Urol 1987; 138(4): 804–6
Botto H, Richard F, Mathieu F, et al. Decapeptyl in the treatment of metastatic prostatic cancer: comparative study with pulpectomy. Prog Clin Biol Res 1987; 243A: 199–206
Botto H, Richard F, Mathieu F, et al. Decapeptyl in the treatment of advanced prostate cancer: comparative study with pulpectomy. Prog Clin Biol Res 1989; 303: 53–60
DeSy WA, deMeyer JM, Casselman J, et al. A comparative study of a long acting luteinizing hormone releasing hormone agonist (Decapeptyl) and orchiectomy in the treatment of advanced prostatic cancer: preliminary report. Acta Urol Belg 1986; 54(2): 221–9
DeSy WA, DeWilde P, DeMeyer JM, et al. Long term experience in the treatment of advanced prostatic cancer with decapeptyl, compared to orchiectomy. Acta Urol Belg 1988; 56(4): 581–8
Hedlund PO, Henriksson P. Parenteral estrogen versus total androgen ablation in the treatment of advanced prostate carcinoma: effects on overall survival and cardiovascular mortality. The Scandinavian Prostatic Cancer Group (SPCG)-5 Trial Study. Urology 2000Mar; 55(3): 328–33
Hedlund PO, Ala-Opas M, Brekkan E, et al. Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer: Scandinavian Prostatic Cancer Group (SPCG) Study No. 5. Scand J Urol Nephrol 2002; 36(6): 405–13
Mathe G, Schally AV, Comaru-Schally AM, et al. Phase II trial with D-Trp-6-LH-RH in prostatic carcinoma: comparison with other hormonal agents. Prostate 1986; 9(4): 327–42
Parmar H, Phillips RH, Lightman SL, et al. Randomised controlled study of orchidectomy vs long-acting D-Trp-6-LHRH microcapsules in advanced prostatic carcinoma. Lancet 1985Nov 30; II(8466): 1201–5
Parmar H, Edwards L, Phillips RH, et al. Orchiectomy versus long-acting D-Trp-6-LHRH in advanced prostatic cancer. Br J Urol 1987Mar; 59(3): 248–54
Parmar H, Phillips RH, Lightman SL, et al. How would you like to have an orchidectomy for advanced prostatic cancer? Am J Clin Oncol 1988; 11 Suppl. 2: S160–8
Abbou CC, Lucas C, Leblanc V. Tolerance and clinical and biological responses during the first 6 months of treatment with 1-month sustained release LHRH agonists leuprolerin and triptolerin in patients with metastatic prostate cancer [in French]. Prog Urol 1997Dec; 7(6): 984–95
Heyns CF, Simonin M-P, Grosgurin P, et al. Comparative efficacy of triptorelin pamoate and leuprolide acetate in men with advanced prostate cancer. BJU Int 2003Aug; 92(3): 226–231
Kuhn JM, Abourachid H, Brucher P, et al. A randomized comparison of the clinical and hormonal effects of two GnRH agonists in patients with prostate cancer. Eur Urol 1997; 32(4): 397–403
Wenderoth UK, Spindler HW, Ehrenthal W, et al. Metastatic prostate cancer under long term pernasal buserelin or intramuscular decapeptyl depot treatment. Prog Clin Biol Res 1987; 243A: 207–20
Jacobi GH, Wenderoth UK, Ehrenthal W, et al. Endocrine and clinical evaluation of 107 patients with advanced prostatic carcinoma under long-term pernasal buserelin or intramuscular decapeptyl depot treatment. Am J Clin Oncol 1988; 11 Suppl. 1: S36–43
Labrie F, Dupont A, Belanger A, et al. Combined antiandrogen treatment in adenocarcinoma of the prostate: first use of a new therapeutically efficacious principle in hormone-dependent cancer [in French]. Ann Urol (Paris) 1986; 20(2): 98–106
Labrie F, Dupont A, Giguere M, et al. Combination therapy with flutamide and castration (orchiectomy or LHRH agonist): the minimal endocrine therapy in both untreated and previously treated patients. J Steroid Biochem 1987; 27(1–3): 525–32
Laufer M, Denmeade SR, Sinibaldi VJ, et al. Complete androgen blockade for prostate cancer: what went wrong? J Urol 2000; 164: 3–9
Klotz L. Hormone therapy for patients with prostate carcinoma. Cancer 2000; 88: 3009–14
Sciarra A, Monti S, Gentile V, et al. Variation in chromogranin A serum levels during intermittent versus continuous androgen deprivation therapy for prostate adenocarcinoma. Prostate 2003May 15; 55(3): 168–79
Sciarra A, DiChiro C, DiSilverio F. Intermittent androgen deprivation (IAD) in patients with biochemical failure after radical retropubic prostatectomy (RRP) for clinically localized prostate cancer. World J Urol 2000Dec; 18(6): 392–400
Gobet DA, Knonagel H, Hauri D. Endocrine treatment prior to radical retropubic prostatectomy in patients with T3 prostate cancer: a retrospective study of 22 patients. Urol Int 1992; 49(3): 141–5
Haggman M, Hellstrom M, Aus G, et al. Neoadjuvant GnRH-agonist treatment (triptorelin and cyproterone acetate for flare protection) and total prostatectomy. Eur Urol 1993; 24(4): 456–60
Hellstrom M, Haggman M, Brandstedt S, et al. Histopathological changes in androgen-deprived localized prostatic cancer: a study in total prostatectomy specimens. Eur Urol 1993; 24(4): 461–5
Aus G. Prostate cancer: mortality and morbidity after non-curative treatment with aspects on diagnosis and treatment. Scand J Urol Nephrol Suppl 1994; 167: 1–41
Hugosson J, Abrahamsson PA, Ahlgren G, et al. The risk of malignancy in the surgical margin at radical prostatectomy reduced almost three-fold in patients given neo-adjuvant hormone treatment. Eur Urol 1996; 29(4): 413–9
Hellstrom M, Haggman M, Pedersen K, et al. A 3-year follow-up of patients with localized prostate cancer operated on with or without pre-treatment with the GnRH-agonist triptorelin. Br J Urol 1996Sep; 78(3): 432–6
Aus G, Abrahamsson PA, Ahlgren G, et al. Hormonal treatment before radical prostatectomy: a 3-year follow-up. J Urol 1998Jun; 159(6): 2013–6
Brandstedt S, Busch C, Hellstrom M, et al. Neo-adjuvant GnRH therapy and radical prostatectomy: effects on tumorous and benign tissue volumes: a morphometric study. Urol Res 1997; 25(1): 43–7
Hellstrom M, Ranepall P, Wester K, et al. Effect of androgen deprivation on epithelial and mesenchymal tissue components in localized prostate cancer. Br J Urol 1997Mar; 79(3): 421–6
van der Kwast TH, Tetu B, Candas B, et al. Prolonged neoadjuvant combined androgen blockade leads to a further reduction of prostatic tumor volume: three versus six months of endocrine therapy. Urology 1999Mar; 53(3): 523–9
Pilepich MV, Winter K, John MJ, et al. Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001; 50: 1243–52
Aus G, Abrahamsson PA, Ahlgren G, et al. Three-month neoadjuvant hormonal therapy before radical prostatectomy: a 7-year follow-up of a randomized controlled trial. BJU Int 2002Oct; 90(6): 561–6
Lissoni P, Cazzaniga M, Tancini G, et al. Reversal of clinical resistance to LHRH analogue in metastatic prostate cancer by the pineal hormone melatonin: efficacy of LHRH analogue plus melatonin in patients progressing on LHRH analogue alone. Eur Urol 1997; 31(2): 178–81
Koutsilieris M, Tzanela M, Dimopoulos T. Novel concept of antisurvival factor (ASF) therapy produces an objective clinical response in four patients with hormone-refractory prostate cancer: case report. Prostate 1999Mar 1; 38(4): 313–6
Koutsilieris M, Mitsiades C, Dimopoulos T, et al. A combination therapy of dexamethasone and somatostatin analog reintroduces objective clinical responses to LHRH analog in androgen ablation-refractory prostate cancer patients. J Clin Endocrinol Metab 2001Dec; 86(12): 5729–36
Iversen P, Melezinek I, Schmidt A. Nonsteroidal antiandrogens: a therapeutic option for patients with advanced prostate cancer who wish to retain sexual interest and function. BJU Int 2001; 87: 47–56
Spetz AC, Hammar M, Lindberg B, et al. Prospective evaluation of hot flashes during treatment with parenteral estrogen or complete androgen ablation for metastatic carcinoma of the prostate. J Urol 2001Aug; 166(2): 517–20
Mathe G, Schally AV, Comaru-Schally AM, et al. Monitoring and treatment of minimal residual cancer of the prostate. Bull Soc Sci Med Grand Duche Luxemb 1989; 126(1): 65–74
Lemay A. Clinical appreciation of LHRH analogue formulations. Horm Res 1989; 32 Suppl. 1: 93–101
Goldman GA, Schoenfeld A, Ovadia J, et al. The impact of D-Trp6 LH-RH on plasma lipid levels. J Assist Reprod Genet 1996Mar; 13(3): 223–7
Eckstein N, Pines A, Fisman EZ, et al. The effect of the hypoestrogenic state, induced by gonadotropin-releasing hormone agonist, on Doppler-derived parameters of aortic flow. J Clin Endocrinol Metab 1993Oct; 77(4): 910–2
Penotti M, Farina M, Gabrielli L, et al. Gonadotropin-releasing hormone agonist-induced hypoestrogenism and blood flows in cerebral arteries. Fertil Steril 1996Aug; 66(2): 240–3
Goldman GA, Tadir Y, Ovadia J, et al. The impact of D-Trp6 luteinizing hormone-releasing hormone (LH-RH) on carbohydrate metabolism. J Assist Reprod Genet 1993Jan; 10(1): 78–81
Barreca T, Martorana G, Franceschini R, et al. Suppression of testicular androgenesis by D-tryptophan-6-luteinizing hormone-releasing hormone does not affect TSH secretion in male subjects. Horm Res 1986; 23(3): 181–4
Wenderoth UK, Jacobi GH. Long-term endocrine profiles of prostatic carcinoma patients under pernasal as well as intramuscular Gn-RH analogue treatment. Prog Clin Biol Res 1985; 185A: 297–305
Decensi A, Torrisi R, Fontana V. Stimulation of erythropoiesis by the non-steroidal anti-androgen nilutamide in men with prostate cancer: evidence for an agonistic effect? Br J Cancer 1994Mar; 69(3): 617–9
Waibel-Treber S, Minne HW, Scharia SH, et al. Reversible bone loss in women treated with GnRH-agonists for endometriosis and uterine leiomyoma. Hum Reprod 1989May; 4(4): 384–8
Scharia SH, Minne HW, Waibel-Treber S, et al. Bone mass reduction after estrogen deprivation by long-acting gonadotropin-releasing hormone agonists and its relation to pretreatment serum concentrations of 1,25-dihydroxyvitamin D3. J Clin Endocrinol Metab 1990Apr; 70(4): 1055–61
Eckstein N, Foldes J, Feinstein Y, et al. Calcium homeostasis, bone metabolism and safety aspects during long-term treatment with a GnRH agonist. Maturitas 1992Aug; 15(1): 25–32
Rico H, Arnanz F, Revilla M, et al. Total and regional bone mineral content in women treated with GnRH agonists. Calcif Tissue Int 1993May; 52(5): 354–7
Poiraudeau S, Roux C, DeCeuninck F, et al. Circulating insulin-like growth factor system changes in women with acute estrogen deficiency induced by GnRH agonist. Osteoporos Int 1997; 7(5): 463–70
Borderie D, Cherruau B, Dougados M, et al. Biochemical markers as predictors of bone mineral density changes after GnRH agonist treatment. Calcif Tissue Int 1998Jan; 62(1): 21–5
Saggese G, Bertelloni S, Baroncelli GI, et al. Reduction of bone density: an effect of gonadotropin releasing hormone analogue treatment in central precocious puberty. Eur J Pediatr 1993Sep; 152(9): 717–20
Verrotti A, Chiarelli F, Montanaro AF, et al. Bone mineral content in girls with precocious puberty treated with gonadotropin-releasing hormone analog. Gynecol Endocrinol 1995Dec; 9(4): 277–81
Compston JE, Yamaguchi K, Croucher PI, et al. The effects of gonadotrophin-releasing hormone agonists on iliac crest cancellous bone structure in women with endometriosis. Bone 1995Feb; 16(2): 261–7
Roux C, Pelissier C, Listrat V, et al. Bone loss during gonadotropin releasing hormone agonist treatment and use of nasal calcitonin. Osteoporos Int 1995May; 5(3): 185–90
Zamberlan N, Castello R, Gatti D, et al. Intermittent Etidronate partially prevents bone loss in hirsute hyperandrogenic women treated with GnRH agonist. Osteoporos Int 1997; 7(2): 133–7
Revilla R, Revilla M, Hernandez ER, et al. Evidence that the loss of bone mass induced by GnRH agonists is not totally recovered. Maturitas 1995Sep; 22(2): 145–50
Berrutti A, Tucci M, Terrone C, et al. Background to and management of treatment-related bone loss in prostate cancer. Drugs Aging 2002; 19(12): 899–910
Goldray D, Weisman Y, Jaccard N, et al. Decreased bone density in elderly men treated with the gonadotropin-releasing hormone agonist decapeptyl (D-Trp6-GnRH). J Clin Endocrinol Metab 1993Feb; 76(2): 288–90
Maillefert JF, Sibilia J, Michel F, et al. Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostatic carcinoma. J Urol 1999Apr; 161(4): 1219–22
Giberti C, Barreca T, Martorana G, et al. Hormonal pattern and testicular histology in patients with prostatic cancer after long-term treatment with a gonadotropin-releasing hormone agonist analogue. Eur Urol 1988; 15(1–2): 125–7
Rolandi E, Franceschini R, Giberti C, et al. Sustained impairment of pituitary and testicular function in prostatic cancer patients treated with a depot form of a GnRH agonist. Horm Res 1988; 30(1): 22–5
Decensi A, Torrisi R, Fontana V, et al. Long-term endocrine effects of administration of either a non-steroidal antiandrogen or a luteinizing hormone-releasing hormone agonist in men with prostate cancer. Acta Endocrinol (Copenh) 1993Oct; 129(4): 315–21
Decensi AU, Guarneri D, Marroni P, et al. Evidence for testicular impairment after long-term treatment with a luteinizing hormone-releasing hormone agonist in elderly men. J Urol 1989Nov; 142(5): 1235–8
Sartor O. Eligard: leuprolide acetate in a novel sustained-release delivery system. Urology 2003Feb; 61(2 Suppl. 1): 25–31
Swanson LJ, Seely JH, Garnick MB. Gonadotropin-releasing hormone analogs and prostatic cancer. Crit Rev Oncol Hematol 1988; 8(1): 1–26
Wirth MP, Froehner M. Value of endocrine therapy for early and locally advanced prostate cancer. Drugs Aging 2003; 20(2): 115–24
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Heyns, C.F. Triptorelin in the Treatment of Prostate Cancer. Am J Cancer 4, 169–183 (2005). https://doi.org/10.2165/00024669-200504030-00004
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DOI: https://doi.org/10.2165/00024669-200504030-00004