Dr. Mark on the Use of Degarelix in Men With Prostate Cancer

James Ryan Mark, MD, assistant professor, Sidney Kimmel Cancer Center, Thomas Jefferson Hospital, discusses the use of degarelix (Firmagon) in the treatment of men with prostate cancer.

Some of the early trials with degarelix showed rapid prostate-specific antigen (PSA) reduction and decreased risk of cardiovascular incidence. There was not, however, any overall survival data, so physicians do not know that an antagonist is better than an agonist, says Mark. There is a large trial that is about to roll out from Ferring Pharmaceuticals that will look at whether the addition of degarelix to androgen deprivation therapy (ADT) will lower cardiovascular events in men with previous cardiovascular disease.

Physicians do not know for sure that an LHRH agonist is inferior to a GnRH antagonist. Mark states that there is a signal of decreased cardiovascular disease in men who have a history of cardiovascular disease. The PRONOUNCE trial will further explore the use of degarelix in men who have a history of cardiovascular disease. The primary outcome of this trial is cardiovascular events.