Neal D. Shore, MD, FACS Discusses Impact, Treatment Implications of the Phase III HERO Trial

Results presented at the 2020 ASCO Virtual Scientific Program demonstrated that once daily oral relugolix (Relumina), a gonadotrophin-releasing hormone (GnRH) antagonist, induced sustained castration in 96.7% of patients with advanced prostate cancer, meeting the trial’s primary endpoint. These findings met the superiority threshold for relugolix when compared with leuprolide (Lupron).

In an interview with CancerNetwork, Neal D. Shore, MD, FACS of the Carolina Urologic Research Center discussed the significance of these findings and the benefits of relugolix as a GnRH antagonist.

Transcription:

So, if I could summarize how this new once daily oral GnRH antagonist medication could change the landscape of treatment for our patients with advanced prostate cancer, I would say that historically and contemporaneously, we only have a parenteral administration of testosterone (T) suppression medications, whether they're given intramuscularly or subcutaneously, or by an implant. This trial, the HERO trial, now has established that once daily oral relugolix, a GnRH antagonist so you don't get surge of testosterone you avoid clinical flare, will offer patients and physicians another significant tool to consider for achieving testosterone suppression not only because it is highly effective in achieving testosterone suppression, but if patients choose to stop medication, their testosterone recovery is much faster so they get back to the benefits of having normal testosterone. And even more significantly, the mechanism of action of an antagonist over an agonist will afford patients and physicians some comfort in knowing that there's a marked decrease in the risk of having a cardiovascular event. Interestingly, during this time of concern, as it relates to the COVID pandemic, patients can take medication at home and don't necessarily need to come into the clinic and put themselves at risk for receiving a parental injection as well as the healthcare team. So, I think these are all very significant developments.