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Considerations for the use of gonadotropin-releasing hormone agonists and antagonists in patients with prostate cancer

Van Poppel, Hendrik and Abrahamsson, Per Anders LU (2020) In International Journal of Urology 27(10). p.830-837
Abstract

Prostate cancer is the second most common cause of cancer-related deaths in men, representing a major source of morbidity and mortality. Androgen deprivation therapy is the primary treatment for patients with advanced prostate cancer at disease presentation, which can be achieved either with surgical or chemical castration. The development of gonadotropin-releasing hormone agonists revolutionized the treatment of advanced prostate cancer, replacing the need for surgical castration. Agonists downregulate gonadotropin-releasing hormone agonist receptors in the pituitary gland, and thus decrease the release of luteinizing hormone and testosterone. Although agonists are a common therapeutic option to date, their use is associated with... (More)

Prostate cancer is the second most common cause of cancer-related deaths in men, representing a major source of morbidity and mortality. Androgen deprivation therapy is the primary treatment for patients with advanced prostate cancer at disease presentation, which can be achieved either with surgical or chemical castration. The development of gonadotropin-releasing hormone agonists revolutionized the treatment of advanced prostate cancer, replacing the need for surgical castration. Agonists downregulate gonadotropin-releasing hormone agonist receptors in the pituitary gland, and thus decrease the release of luteinizing hormone and testosterone. Although agonists are a common therapeutic option to date, their use is associated with testosterone surges, metabolic dysfunction and an increase in the risk of cardiovascular disease; they might contribute to tumor flares and potentially an increase in non-cancer mortality. More recently, gonadotropin-releasing hormone antagonists have entered the prostate cancer treatment landscape. Unlike agonists, antagonists directly inhibit the androgen receptor in the pituitary gland, and thus do not cause initial testosterone surges. In this article, we provide a concise review of the mechanism of actions, safety and efficacy of the approved agonists and antagonists for prostate cancer treatment.

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author
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organization
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type
Contribution to journal
publication status
published
subject
keywords
androgen deprivation therapy, castration, gonadotropin-releasing hormone agonist, gonadotropin-releasing hormone antagonist, luteinizing hormone-releasing hormone agonists, prostate cancer
in
International Journal of Urology
volume
27
issue
10
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:32662187
  • scopus:85087793042
ISSN
0919-8172
DOI
10.1111/iju.14303
language
English
LU publication?
yes
id
66842183-a8fe-4b80-b913-bb01b695a741
date added to LUP
2020-07-22 13:10:35
date last changed
2024-05-01 13:42:55
@article{66842183-a8fe-4b80-b913-bb01b695a741,
  abstract     = {{<p>Prostate cancer is the second most common cause of cancer-related deaths in men, representing a major source of morbidity and mortality. Androgen deprivation therapy is the primary treatment for patients with advanced prostate cancer at disease presentation, which can be achieved either with surgical or chemical castration. The development of gonadotropin-releasing hormone agonists revolutionized the treatment of advanced prostate cancer, replacing the need for surgical castration. Agonists downregulate gonadotropin-releasing hormone agonist receptors in the pituitary gland, and thus decrease the release of luteinizing hormone and testosterone. Although agonists are a common therapeutic option to date, their use is associated with testosterone surges, metabolic dysfunction and an increase in the risk of cardiovascular disease; they might contribute to tumor flares and potentially an increase in non-cancer mortality. More recently, gonadotropin-releasing hormone antagonists have entered the prostate cancer treatment landscape. Unlike agonists, antagonists directly inhibit the androgen receptor in the pituitary gland, and thus do not cause initial testosterone surges. In this article, we provide a concise review of the mechanism of actions, safety and efficacy of the approved agonists and antagonists for prostate cancer treatment.</p>}},
  author       = {{Van Poppel, Hendrik and Abrahamsson, Per Anders}},
  issn         = {{0919-8172}},
  keywords     = {{androgen deprivation therapy; castration; gonadotropin-releasing hormone agonist; gonadotropin-releasing hormone antagonist; luteinizing hormone-releasing hormone agonists; prostate cancer}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{830--837}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{International Journal of Urology}},
  title        = {{Considerations for the use of gonadotropin-releasing hormone agonists and antagonists in patients with prostate cancer}},
  url          = {{http://dx.doi.org/10.1111/iju.14303}},
  doi          = {{10.1111/iju.14303}},
  volume       = {{27}},
  year         = {{2020}},
}