Application of initial doses of LHRH analogues and maintenance doses of LHRH antagonists for the treatment of hormone-dependent cancers and corresponding pharmaceutical kits
LHRH analogs and LHRH antagonists for use in the treatment or prophylaxis of hormone-dependent cancers, in particular prostate cancer, prostate carcinoma and/or advanced prostate carcinoma, by administering an initial dose of an LHRH analog over a first period sufficient to effect hormonal castration, then administering a maintenance dose of an LHRH antagonist over a second period, the dose being insufficient to achieve and/or maintain hormonal castration.
1. A method for the treatment of hormone-dependent cancers comprising a first period and a second period; wherein hormonal castration as indicated by a testosterone blood level of 1.2 ng/mL or lower is not maintained during the second period, comprising:
a) administering to a patient in need thereof an initial dose of at least one LHRH analogue over the first period, the total amount of LHRH analogue in the dose being sufficient to effect hormonal castration such that a testosterone blood level is less than 1.2 ng/ml, wherein the initial dose is 65 mg to 300 mg, followed by
b) administration of a maintenance dose of at least one LHRH antagonist in an amount of from 1 to 65 mg over the second period which comprises at least 30 days, the total amount of LHRH antagonist in the maintenance dose being insufficient to achieve or maintain a testosterone blood level of 1.2 ng/mL or lower, and wherein at least temporarily the patient's individual blood level of Prostate Specific Antigen (PSA) is equal to or below 20 ng/ml.
2. The method according to claim 1 , wherein the patient is a human.
3. The method according to claim 1 , wherein dose of the at least one LHRH antagonist comprises at least one compound selected from the group consisting of abarelix, antide, azaline B, A-75998, cetrorelix, degarelix, detirelix, ozarelix (D-63153), ganirelix, Nal-Glu-Antagonist, ramorelix, RS-68439, teverelix.
4. The method according to claim 1 , wherein the dose of the at least one LHRH analogue comprises at least one LHRH antagonist selected from the group consisting of abarelix, antide, azaline B, A-75998, cetrorelix, degarelix, detirelix, ozarelix (D-63153), ganirelix, Nal-Glu-Antagonist, ramorelix, RS-68439, teverelix.
5. The method according to claim 1 , wherein the dose comprising at least one LHRH analogue of a) comprises at least one LHRH agonist selected from the group consisting of goserelin, leuprorelin (leuprolide), triptorelin, buserelin, nafarelin, historelin, and deslorelin.
6. The method according to claim 1 , wherein in a) the first period comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 months.
7. The method according to claim 1 , wherein in b) the second period comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 months.
8. The method according to claim 1 , wherein the patient is a human and wherein in b) the second period lasts from the end of the first period in a) until the patient's individual blood level of Prostate Specific Antigen (PSA) rise to equal or above 20 ng/mL.
9. The method according to claim 1 , wherein the maintenance dose is administered as a monthly single dose every 4 weeks, as a single dose every two months, as a single dose every three months, as a single dose every four months, as a single dose every five months and/or as a single dose every six months.
10. The method according to claim 1 , wherein the initial dose is administered as a monthly single dose every 4 weeks, as a single dose every two months, as a single dose every three months, as a single dose every four months, as a single dose every five months and/or as a single dose every six months.
11. The method according to claim 1 , further comprising repeating a) and b) continuously.
12. The method according to claim 1 , wherein the hormone-dependent cancer is selected from the group consisting of prostate cancer, prostate carcinoma and advanced prostate carcinoma.