degarelix + relugolix

Degarelix and relugolix are both gonadotropin-releasing hormone (GnRH) receptor antagonists used for androgen deprivation therapy (ADT) in advanced prostate cancer. These are **not typically administered together** as a combination therapy but are separate treatment options within the same drug class. **Degarelix** is an injectable GnRH receptor antagonist administered via subcutaneous injection every 28 days. It's approved for advanced prostate cancer and maintains low testosterone levels. A notable drawback is potential intense pain at the injection site. **Relugolix** is a first-in-class, oral, highly selective nonpeptide GnRH receptor antagonist taken once daily. It was approved based on the HERO trial, showing rapid and sustained testosterone suppression superior to leuprolide acetate. As the only oral ADT option, it offers convenience, faster testosterone recovery after discontinuation, and a lower risk of major adverse cardiovascular events compared to leuprolide. Studies show higher adherence rates and longer median time to discontinuation for relugolix compared to degarelix and GnRH agonists. Both medications are effective for ADT in advanced prostate cancer, with selection depending on patient factors, cardiovascular risk, and adherence considerations.