Susan F. Slovin, MD, PhD
Preliminary data suggest that patients with cardiovascular disease being treated for metastatic prostate cancer may experience fewer cardiovascular events when treated with a GnRH antagonist, such as degarelix (Firmagon), compared with a GnRH agonist.
, Susan F. Slovin, MD, PhD, the co-principal investigator of PRONOUNCE and a medical oncologist at Memorial Sloan Kettering Cancer Center, discussed this multinational study and how the results may affect the treatment of patients with prostate cancer.
OncLive: Can you first describe the difference between an agonist and an antagonist?
A GnRH agonist, such as leuprolide, essentially tells the brain not to send a signal to the gonads to make testosterone. Because there is a feedback loop between the brain and the gonads, the gonads immediately start to make more testosterone to try to get the attention on the brain and say, "Here I am. Tell me what to do." Over a period of time, that connection just does not happen. The testes shut down, and it also has to do with follicle-stimulating and luteinizing hormones, but the point is that, at the end of the day, the testes do not receive that signal. They shut down, and the man goes through the equivalent of a chemically induced menopause.
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