Journal Mobile Options
Table of Contents
Vol. 93, No. 2, 2014
Issue release date: September 2014
Urol Int 2014;93:152-159

Degarelix versus Goserelin plus Bicalutamide Therapy for Lower Urinary Tract Symptom Relief, Prostate Volume Reduction and Quality of Life Improvement in Men with Prostate Cancer: A Systematic Review and Meta-Analysis

Cui Y. · Zong H. · Yan H. · Li N. · Zhang Y.
Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Objective: We performed a systematic review and meta-analysis to assess the efficacy and tolerability of degarelix for lower urinary tract symptom relief, prostate volume reduction and quality of life improvement in men with prostate cancer (PCa). Materials and Methods: A literature review was performed to identify all of the published randomized controlled trials (RCTs) that used degarelix versus gonadotropin-releasing hormone agonists plus antiandrogens therapy for the treatment of PCa. The search included the following databases: MEDLINE, EMBASE and the Cochrane Controlled Trials Register. Results: Three publications involving a total of 466 patients were used in the analysis, including three RCTs that compared degarelix with goserelin plus bicalutamide therapy for PCa over 12 weeks. For the comparison of degarelix with goserelin plus bicalutamide therapy, International Prostate Symptom Score (IPSS) reduction (standardized mean difference [SMD] = -1.85, 95% confidence interval [CI] = -2.97 to -0.72, p = 0.001) and IPSS ≥13 (SMD = -2.68, 95% CI = -4.57 to -0.78, p = 0.006) indicated that decreases in IPSS were greater in degarelix-treated patients than in goserelin plus bicalutamide-treated patients. Conclusions: Our meta-analysis indicates that, compared with goserelin plus bicalutamide, degarelix has significantly more pronounced effects on lower urinary tract symptoms. © 2014 S. Karger AG, Basel

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Huggins C, Hodges C: Studies on prostatic cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res 1941;1:293-297.

    External Resources

  2. Heidenreich A, Bastian PJ, Bellmunt J, et al: Guidelines on Prostate Cancer. Available at (accessed May 2012).
  3. National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology (NCCN Guideline®). Prostate cancer. Version 3.2012. Available at (accessed May 2012).
  4. Wirth M, Hakenberg O, Froehner M: Antiandrogens in the treatment of prostate cancer. Eur Urol 2007;51:306-313.
  5. Kelly W, Gomella L: Androgen deprivation therapy and competing risks. JAMA 2011;306:2382-2383.
  6. Van Poppel H: Evaluation of degarelix in the management of prostate cancer. Cancer Manag Res 2010;2:39-52.
  7. Sugiono M, Winkler MH, Okeke AA, Benney M, Gillatt DA: Bicalutamide versus cyproterone acetate in preventing flare with LHRH analogue therapy for prostate cancer - a pilot study. Prostate Cancer Prostatic Dis 2005;8:91-94.
  8. Jadad AR: Randomised Controlled Trials. London, BMJ Publishing Group, 1998.
  9. Higgins JPT, Green S (eds): Cochrane Handbook for Systematic Reviews of Interventions, v.5.1.0 (updated March 2011).
  10. DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986;7:177-188.
  11. Axcrona K, Aaltomaa S, Da Silva CM, et al: Androgen deprivation therapy for volume reduction, lower urinary tract symptom relief and quality of life improvement in patients with prostate cancer: degarelix vs goserelin plus bicalutamide. BJU Int 2012;110:1721-1728.
  12. Anderson J, Al-Ali G, Wirth M, et al: Degarelix versus goserelin (+ antiandrogen flare protection) in the relief of lower urinary tract symptoms secondary to prostate cancer: results from a phase IIIb study (NCT00831233). Urol Int 2013;90:321-328.
  13. Mason M, Maldonado PX, Steidle C, et al: Neoadjuvant androgen deprivation therapy for prostate volume reduction, lower urinary tract symptom relief and quality of life improvement in men with intermediate- to high-risk prostate cancer: a randomised non-inferiority trial of degarelix versus goserelin plus bicalutamide. Clin Oncol (R Coll Radiol) 2013;25:190-196.
  14. Singer EA, Golijanin DJ, Miyamoto H, Messing EM: Androgen deprivation therapy for prostate cancer. Expert Opin Pharmacother 2008;9:211-228.
  15. Van Poppel H, Nilsson S: Testosterone surge: rationale for gonadotropin-releasing hormone blockers? Urology 2008;71:1001-1006.
  16. Zinner NR, Bidair M, Centeno A, Tomera K: Similar frequency of testosterone surge after repeat injections of goserelin (Zoladex) 3.6 mg and 10.8 mg: results of a randomized open-label trial. Urology 2004;64:1177-1181.
  17. Gittelman M, Pommerville PJ, Persson BE, Jensen JK, Kold OT: A 1-year, open label, randomized phase II dose finding study of degarelix for the treatment of prostate cancer in North America. J Urol 2008;180:1986-1992.
  18. Van Poppel H, Tombal B, de la Rosette JJ, et al: Degarelix: a novel gonadotropin-releasing hormone (GnRH) receptor blocker - results from a 1-yr, multicentre, randomised, phase 2 dosage-finding study in the treatment of prostate cancer. Eur Urol 2008;54:805-813.
  19. Hamilton W, Sharp D: Symptomatic diagnosis of prostate cancer in primary care: a structured review. Br J Gen Pract 2004;54:617-621.

    External Resources

  20. Guess HA: Benign prostatic hyperplasia and prostate cancer. Epidemiol Rev 2001;23:152-158.
  21. Andersson SO, Rashidkhani B, Karlberg L, Wolk A, Johansson JE: Prevalence of lower urinary tract symptoms in men aged 45-79 years: a population-based study of 40,000 Swedish men. BJU Int 2004;94:327-331.
  22. Russo A, Castiglione F, Salonia A, et al: Effects of the gonadotropin-releasing hormone antagonist ganirelix on normal micturition and prostaglandin E(2)-induced detrusor overactivity in conscious female rats. Eur Urol 2011;59:868-874.
  23. Bono AV, Salvadore M, Celato N: Gonadotropin-releasing hormone receptors in prostate tissue. Anal Quant Cytol Histol 2002;24:221-227.

    External Resources

  24. Bahk JY, Kim MO, Park MS, et al: Gonadotropin-releasing hormone (GnRH) and GnRH receptor in bladder cancer epithelia and GnRH effect on bladder cancer cell proliferation. Urol Int 2008;80:431-438.
  25. Tanriverdi F, Gonzalez-Martinez D, Hu Y, Kelestimur F, Bouloux PM: GnRH-I and GnRH-II have differential modulatory effects on human peripheral blood mononuclear cell proliferation and interleukin-2 receptor gamma-chain mRNA expression in healthy males. Clin Exp Immunol 2005;142:103-110.
  26. Gandaglia G, Benigni F, La Croce G, et al: Degarelix reduces urodynamic changes in a rat model for experimental detrusor overactivity and produces more efficient voiding. J Urol 2011;185:e322.
  27. Rick FG, Schally AV, Block NL, et al: LHRH antagonist Cetrorelix reduces prostate size and gene expression of proinflammatory cytokines and growth factors in a rat model of benign prostatic hyperplasia. Prostate 2011;71:736-747.
  28. Siejka A, Schally AV, Block NL, Barabutis N: Mechanisms of inhibition of human benign prostatic hyperplasia in vitro by the luteinizing hormone-releasing hormone antagonist cetrorelix. BJU Int 2010;106:1382-1388.
  29. Giuliano F, Behr-Roussel D, Oger S, et al: Ozarelix, an LHRH antagonist, exerts a direct relaxing effect on human prostate in vitro. J Urol 2009;181:693.

    External Resources

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50