Gonadotropin-releasing hormone agonists in prostate cancer: A comparative review of efficacy and safety.
Level 5 - mechanism / opinion, no new human data
Narrative review without formal systematic review methodology
PubMed 35343198 · doi:10.4103/ijc.IJC_65_21
What was done
The authors reviewed published evidence comparing the efficacy, safety, and administration convenience of various gonadotropin-releasing hormone agonists (goserelin, triptorelin, buserelin, histrelin, and leuprorelin) used for androgen deprivation therapy in prostate cancer.
What was found
All reviewed GnRH agonists suppressed testosterone to ≤50 ng/dL within 1 month and ≤20 ng/dL within 3 months. Goserelin was reported to maintain testosterone ≤50 ng/dL better than leuprolide, with lower testosterone escape rates than buserelin. In neoadjuvant settings, 10-year overall survival ranged from 42.6% to 86% with goserelin alone and was 62% with either goserelin or leuprolide. As adjuvant therapy to radical prostatectomy, 10-year survival with goserelin was 87% versus an 8-year survival of 84.6% with triptorelin. Adjuvant to radiotherapy, goserelin had an absolute survival rate of 49%. Adverse event frequency and severity (hot flushes, fatigue, sexual dysfunction) were comparable across agents.
Why it matters
This review synthesizes comparative outcomes across common GnRH agonists, summarizing survival benchmarks across treatment settings to guide agent selection for androgen deprivation therapy.
Limits
The abstract describes a narrative review without specified systematic search methods, statistical pooling, or participant counts. Reported survival figures reflect heterogeneous, non-head-to-head study cohorts with differing follow-up times and baseline characteristics.
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- supports Lupron was introduced in 1985 as a peptide designed to shut down testosterone production for prostate cancer patients.