Purpose of Review

Androgen deprivation therapy (ADT) is the standard of care for the treatment of advanced prostate cancer (PC). ADT, particularly with GnRH agonists, leads to increased risk of cardiovascular disease, including myocardial infarction, hypertension, and stroke. This review discusses the options of ADT, the mechanism of ADT-associated cardiovascular side effects, and potential benefit by using GnRH antagonists.

Recent Findings

GnRH antagonists have relatively less cardiovascular adverse effects compared to GnRH agonists. We highlight on a recently published phase III clinical trial on the oral GnRH antagonist, relugolix, and its comparative benefit to traditional GnRH agonist regarding development of cardiovascular disease.

Summary

Recent data reinforces that GnRH antagonists have a more favorable cardiovascular outcomes compared to GnRH agonists yet maintain a similar efficacy profile. From the data we reviewed, GnRH antagonists may be the preferred method of ADT for PC, but further data with primary cardiovascular outcomes are warranted.

中文翻译：

---

雄激素剥夺疗法的心血管毒性

 审查目的

雄激素剥夺疗法（ADT）是治疗晚期前列腺癌（PC）的标准治疗方法。 ADT，尤其是 GnRH 激动剂，会导致心血管疾病的风险增加，包括心肌梗塞、高血压和中风。本综述讨论了 ADT 的选择、ADT 相关心血管副作用的机制以及使用 GnRH 拮抗剂的潜在益处。

 最近的发现

与 GnRH 激动剂相比，GnRH 拮抗剂对心血管的不良反应相对较少。我们重点介绍最近发表的一项关于口服 GnRH 拮抗剂 relugolix 的 III 期临床试验，及其与传统 GnRH 激动剂在心血管疾病发展方面的相对益处。

 概括

最近的数据证实，与 GnRH 激动剂相比，GnRH 拮抗剂具有更有利的心血管结局，但仍保持相似的疗效。从我们回顾的数据来看，GnRH 拮抗剂可能是 PC 的首选 ADT 方法，但需要进一步的主要心血管结局数据。