Relugolix prescribing trends in prostate cancer
Relugolix is an oral, once-daily, gonadotropin-releasing hormone (GnRH) receptor antagonist recently approved in the US based on results from the Phase III HERO trial. In the trial, relugolix met the primary endpoint of sustained testosterone suppression through 48 weeks in greater than 90% of patients, significantly improved testosterone suppression over leuprolide, and was also superior to leuprolide in secondary efficacy measurements such as PSA response rate and mean FSH level. Relugolix did not demonstrate superiority over leuprolide for castration resistance-free survival.
Relugolix received a broad label inclusive of all adult patients with advanced prostate cancer. In what prostate cancer settings/patients are you most likely to prescribe relugolix?
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Stewart Polsky, CAROLINA UROLOGY PARTNERS PLLC5yrSeems best for patients needing short-term HMT and those with significant cardiovascular history; potential for rapid recovery of testosterone once medication stopped. Patient cost & compliance will also need to be considered.
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Sherif Badawy5yrMainly I use Relugolix in patients who may get potential clinical benefits and are considered with cardiovascular risk factors, important to take a patient-centered approach
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Thomas Cartwright5yrHERO trial shows a 50% reduction in CV events, so I use it in patients who are at high risk for CV disease. Also I want to make sure patient will be compliant. I believe cost is the same as LHRH drugs. I also consider in patients who will be receiving a short course of ADT or even intermittant therapy.
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Sumit Sawhney5yri would use the drug only in pts who are at high risk for cardio vascular cost of drug is outrageous ,and will need to balance the benefit with risk
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Joseph Renzulli, SOUTH COUNTY UROLOGY5yrI have been trying to use the medication for patients that are looking to have a rapid recovery of testosterone after short-term HMT and those with significant cardiovascular history. I agree with Dr. Abishek that the challenge is approvals for use and patient cost. I have two patients currently. Obviously, compliance is also a potential concern for the oral therapy.
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KUMAR ABHISHEK5yrIn both mHSPC and mCRPC. In combination with either Docetaxel and AR inhibitor. one of the challenges is the cost of therapy, time to get the medicine, approval from insurance, co-pays. I have used at least once in HSPC and we got it for free from the company. The patient felt better than being on Leuprolide. I am enthusiastic about this drug,.