Intermittent LHRH Therapy in the Management of Castrate-resistant Prostate Cancer (CRPCa)

Abstract

We have observed that intermittent ADT in patients with CRPCa, using a testosterone of >1.75 ngmol/L as a trigger to reinitiate LHRHa, results in a substantial cost savings with no negative impact on oncologic and QOL outcomes.

Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review

“…The majority of the included CEA/MEE originated from the United States (US; n = 12) [62–73], three originated from the United Kingdom (UK) [56, 59, 75], two were multi-country [60, 61], one originated from Canada (CAN) [58] and one from the Netherlands [54], respectively. The included COIA originated majorly from the US (n = 6) [74, 75, 78, 80, 84, 87] and CAN (n = 5) [77, 79, 81, 85, 86] as well as from Japan (n = 2) [55, 82], Ireland (n = 1) [76] or Sweden (n = 1) [83], respectively. The included BIA originated from the US (n = 4) [88–91] and the UK (n = 1) [56], respectively.…”

“…The COIA were based majorly on retrospective cohort studies (n = 9) [55, 74, 75, 78, 80–84]. Three COIA used a model approach [76, 79, 86], two were based on randomized controlled trials [85, 87], and one was based on a prospective cohort study [77]. A length of follow-up varying per patient was reported by seven COIA [74, 78, 80–84], whereas the remaining COIA reported a length of follow-up from six to 24 months [55, 75–77, 85, 87] or a lifetime follow-up [79, 86].…”

“…The overall annual direct costs of patients with CRPC and mCRPC ranged from $2,474 [85] to $50,537 [74] and from $26,707 [87] to $67,957 [75], respectively. The annual cancer-specific costs of patients with CRPC and mCRPC ranged from $14,335 [80] to $77,725 [76] and from $3,067 [86] to $73,270 [84], respectively.…”

Quantitative assessment of quality of life in New Zealand prostate cancer survivors: the effect of androgen deprivation therapy

“…Secondly, all of these studies were conducted in North America or Europe, with the North America studies involving data from 1994 and 1995 [9,10]. As ADT treatment protocols have changed considerably since that time and may also differ across countries [14,16], newer studies in other non-North American and European countries may be needed to better quantify the contemporary effect of ADT on QOL in men with prostate cancer. Another issue with these studies may concern the QOL tools used, with the studies generally using the SF-36 [9][10][11] although one study used the EORTC-C30 and sexual behaviour questionnaires (SBQ) [12].…”