Efficacy and Tolerability of the Histrelin Implant (VANTAS<sup>®</sup>)

Research Article

Austin J Urol. 2016; 3(2): 1045.

Efficacy and Tolerability of the Histrelin Implant (VANTAS®)

Rudlang TM and Brasso K*

Department of Urology, Copenhagen Prostate Cancer Center, University of Copenhagen, Denmark

*Corresponding author: Brasso K, Department of Urology, Copenhagen Prostate Cancer Center, University of Copenhagen, Denmark

Received: June 17, 2016; Accepted: July 18, 2016; Published: July 22, 2016


Introduction: Androgen deprivation is the cornerstone in management of patients with advanced or metastatic prostate cancer. Androgen deprivation can be achieved in a number of different ways, all, leading to lowering of testosterone to castrate range. We present our initial experience with a newly introduced oneyear formulation.

Material and Methods: Consecutive patients managed with Histrelin implants. Main out-come, testosterone levels 3 and 12 months following implantation.

Results: Histrelin implants maintained testosterone levels within castration range in all patients 3 and 12 months following implantation. Major side effects were the expected consequences of androgen deprivation, only few patients had complaints related to the implant or procedure.

Conclusion: Histrelin implants may serve as a valid alternative in patients undergoing either permanent or short-term androgen deprivation therapy

Keywords: Androgen deprivation therapy; Histrelin; Prostate cancer; GnRH agonist; Testosterone


Testosterone promotes the cell proliferation and DNA synthesis in the prostate via androgen receptors. Eliminating or blocking the androgen stimulation inhibits proliferation and activates apoptosis in normal prostates and in Prostate Cancer (PC). Androgen Deprivation Therapy (ADT) is the standard care in patients with metastatic prostate cancer [1]. Furthermore, ADT can be used as adjuvant therapy in combination with radiotherapy in patients with localised and locally advanced prostate cancer with curative intent.

Androgen deprivation can be achieved by either bilateral orchiectomy or medical castration using GnRH agonists, GnRH antagonists, or oestrogensaiming to reduce testosterone to castrate levels <1,73 nmol/l. By continuous exposure to GnRH agonists a paradox down regulation in GnRH receptors in the pituitary gland leads to ceased secretion of LH and thereby testosterone suppression as a result.

GnRH agonists are usually administered as subcutaneous or intramuscular injection every 3 to 6 months. Micro-surges in testosterone level, when injections are re-administered, occurs in 4-10% of patients treated with GnRH agonists and may be of significance [2-4].

Histrelin implant (VANTAS®) is a novel subcutaneously administered GnRH agonist. The chemical structure of Histrelin acetate does not differ much from the chemical structure of commonly used GnRH agonists like Goserelin acetate and Leuprolide acetate. However, the potency and receptor affinity of Histrelin is significant higher [5-7]. Recently Histrelin has been introduced as an alternative to other GnRH agonists in the management of advanced PCa. The implant is a permeable hydrogel device measuring 3,5 cm in length and 3,5 mm in diameter and comprise 50 mg Histrelin acetate, providing a continuous daily release of 50 mg Histrelin for a period of 52 weeks, (Figure 1). We report our initial single institution experience with this newly introduced device.