Gn-RH agonists in the treatment of prostatic carcinoma.

About 80% of advanced prostate cancers are hormone dependent. Androgen withdrawal by either surgical castration or medical castration is the first-line treatment for this disease. As the patient's choice and quality of life are now being taken into account, reversible medical castration with GnRH analogues has emerged as a new palliative treatment. The use of these compounds alone or in combination with anti-androgens and the timing of initiating the hormone therapy were reviewed. Unfortunately, relapses after androgen ablation occur in most patients, as their cancer becomes insensitive to androgens. Management of hormonal refractory cancer remains a challenge to clinicians. No clinical trial using promising new therapeutic approaches such as GnRH antagonists, GnRH analogues linked to cytotoxic radicals, or a combination of GnRH analogues with somatostatin analogues or bombesin/GRP antagonists have been published until now.