Dr. Slovin on the Promise of GnRH Antagonists in Prostate Cancer

Susan F. Slovin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the promise of GnRH antagonists in prostate cancer.

The multicenter, randomized, controlled trial PRONOUNCE is comparing the occurrence of major adverse cardiovascular events in patients with prostate cancer and cardiovascular disease receiving the GnRH antagonist degarelix (Firmagon) or the GnRH agonist leuprolide (NCT02663908). Preliminary data have suggested that patients with cardiovascular disease being treated for metastatic prostate cancer may experience fewer cardiovascular events when treated with a GnRH antagonist compared with a GnRH agonist.

If this study is positive, Slovin says that it will likely cause a change in clinical practice, and clinicians will be using a GnRH antagonist more routinely. By giving patients a GnRH antagonist, there will no longer be a need to use an antiandrogen, which is given before an injection of a GnRH agonist. Additionally, Slovin says that treatment with a GnRH antagonist guarantees castrate levels within 24 to 48 hours, which is faster than a GnRH agonist.