Lupron and Zytiga – pro
ZYTIGA in combination with prednisone was initially FDA indicated for the treatment of patients with metastatic castration-resistant prostate cancer (CRPC) who have received prior chemotherapy containing docetaxel. Abiraterone acetate (ZYTIGA) is converted in vivo to abiraterone, an androgen biosynthesis inhibitor, that inhibits 17 -hydroxylase/C17,20-lyase (CYP17). This enzyme is expressed in testicular, adrenal, and prostatic tumor tissues and is required for androgen biosynthesis.This effect is independent of previous exposure to docetaxel.
In the 2017of the American Society of Clinical Oncology (ASCO), there were presented the results from a randomized phase II study showing that 6 months of treatment with abiraterone (Zytiga) in addition to the hormone therapy leuprolide before prostatectomy resulted in complete response and near-complete response in one-third of men with high-risk prostate cancer
NCCN lists leuprolide with a 2nd generation anti-androgen.
Taplin ME, Montgomery RB, Logothetis C, et al. Effect of neoadjuvant abiraterone acetate (AA) plus leuprolide acetate (LHRHa) on PSA, pathological complete response (pCR), and near pCR in localized high-risk prostate cancer (LHRPC): Results of a randomized phase II study. J Clin Oncol. 2012;30:(suppl; abstr 4521).
Mary-Ellen Taplin, Bruce Montgomery, Christopher J. Logothetis, Glenn J. Bubley, Jerome P. Richie, Bruce L. Dalkin, Intense Androgen-Deprivation Therapy With Abiraterone Acetate Plus Leuprolide Acetate in Patients With Localized High-Risk Prostate Cancer: Results of a Randomized Phase II Neoadjuvant Study Journal of Clinical Oncology 32, no. 33 (November 2014) 3705-3715.
Efstathiou E, Davis JW, Titus MA, et al. Neoadjuvant enzalutamide (ENZA) and abiraterone acetate (AA) plus leuprolide acetate (LHRHa) versus AA+ LHRHa in localized high-risk prostate cancer (LHRPC). J Clin Oncol. 2016; 34 (suppl; abstr 5002).
NCCN, PROS-F 2017