Dr Snuffy Myers now prefers Firmagon (degarelix) over Lupron for men with advanced prostate cancer

[JimJimJimJim]

Jim Marshall (not a doctor) said ... 

After 15 years of recommending an LHRH angonists:

• (Zoladex (Goserelin), Lupron (leuprorelin), Eligard (leuprolide), Lucrin (leuprorelin acetate),  Suprefact (buserelin), Suprecor (buserelin), Synarel (nafarelin), histrelin (Supprelin), Suprelorin (deslorelin), Ovuplant(deslorelin), Triptorelin),

in combination with an antiandrogen like:

• Cosudex

to start men on hormone therapy, Dr Snuffy Myers is changing his recommendation to men on hormone therapy with metastases to lymph nodes or bone to using the LHRH antagonist:

• Firmagon (degarelix) alone.

 

His initial reservations about Firmagon (degarelix) revolved around the injection site pain for the monthly injection.

 

For advanced patients with bone metastases, the USA Federal Drugs Administration (FDA) has approved Firmagon (degarelix) for the first month of treatment, changing to Lupron after that.

 

But with 3 more years of evidence, and listening to a presentation by lead researcher Dr David Crawford, has come to the belief that Firmagon (degarelix) should be used continuously for these men.

 

Firmagon (degarelix) is available on the PBS (Pharmaceutical Benefits Scheme) in Australia for Locally advanced (equivalent to stage C) or metastatic (equivalent to stage D) carcinoma of the prostate.

... end Jim

 

Dr Snuffy Myers gives an account of how Firmagon (degarelix) works, and his reasons for the change in this video:

 

https://askdrmyers.wordpress.com/2013/02/27/firmagon/

[Paul Edwards]

I had a discussion with my oncologist this week about Firmagon and Snuffy Myers' video. He said that he often used Firmagon once Lupron ceased to be effective. 

 

His concern about using Firmagon as a first-line treatment was the injection site pain involved with the monthly injection.  His patients when using Firmagon complained about pain and swelling which lasted 2 to 3 days.

 

Googling the side effects, you find commentary such as "it [the study data] does not factor in the significant potential risk of very severe localized injection site responses that seem to be experienced by many men who have chosen to use Firmagon, making it unusable by many".

 

A three monthly Lupron injection with no injection site pain or a monthly Firmagon injection with severe injection site pain?  For me, the choice was easy - I'm sticking with Lupron for the time being.