GnRH agonist or antagonist? Challenges and optimizations of medical castration therapy for prostate cancer
10.3969/j.issn.1009-8291.2025.05.001
- VernacularTitle:GnRH激动剂还是拮抗剂?前列腺癌去势治疗的挑战与优化
- Author:
Tao XU
1
;
Weiyu ZHANG
1
Author Information
1. Department of Urology, Peking University People's Hospital, Beijing 100044, China
- Publication Type:Journal Article
- Keywords:
prostate cancer;
medical castration therapy;
androgen deprivation therapy;
gonadotropin hormone-releasing hormone agonist;
gonadotropin hormone-releasing hormone antagonist;
medication adverse events
- From:
Journal of Modern Urology
2025;30(5):367-374
- CountryChina
- Language:Chinese
-
Abstract:
Androgen deprivation therapy (ADT) is considered the standard treatment for advanced and metastatic prostate cancer.The most commonly used drugs in this therapy are gonadotropin hormone-releasing hormone (GnRH) agonists and GnRH antagonists. Both types of drugs exert their therapeutic effects through the endocrine system，but their mechanisms of action differ significantly. GnRH agonists activate the GnRH receptor，leading to a negative feedback mechanism，whereas GnRH antagonists directly bind to the GnRH receptor and block the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These differences result in varying clinical outcomes. This paper provides a systematic comparison of the two types of drugs in terms of efficacy，safety，adverse events，and improvements of lower urinary tract symptoms (LUTS) in different clinical scenarios. Additionally，the paper also discusses the benefits of switching between these two treatment options and the future directions of ADT，aiming to offer practical insights to clinicians for the optimal use of these therapies.
