Episode 324: Pharmacology 101: LHRH Antagonists and Agonists
Release Date: 08/09/2024
The ONS Podcast
“The response was, in my opinion, sort of overwhelmingly positive. I think all of us old-timers who were at ONS Congress® in 1986 remember those 1,600 nurses waiting in line to enter the ballroom to take that inaugural exam. It takes a while to check in 1,600 people. They kind of all filled up the lobby outside of the ballroom, and then they spilled over down into the escalator, and the escalators had to be turned off,” Cyndi Miller-Murphy, MSN, FAAN, CAE, first executive director of the Oncology Nursing Certification Corporation (ONCC), told Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, ONS...
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“Now, what we found is that epigenetics is actually heritable and it’s actually reversible. And we can now manipulate these principles with pharmacotherapy drugs,” Eric Zack, RN, OCN®, BMTCN®, clinical assistant professor at Loyola College Chicago Marcella Niehoff School of Nursing in Chicago, IL, and RN3 at Rush University Medical Center in Chicago, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the epigenetics drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by...
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“It is very much a collaborative group process. There are group meetings where we come to consensus on our different ratings. There’s so much support from ONS staff, even amongst our different groups, even when you’re assigned to one peer reviewer. Let’s say you go on vacation, sometimes we’re paired with other people, too. So there is some flexibility in the opportunity as well,” Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®, lecturer at Old Dominion University in Norfolk, VA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...
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“This is what totally drives the treatment decisions, and that’s why having that pathology report when the nurse is educating the patient is so important, because you can say, well, you have this kind of breast cancer, and this kind of breast cancer is generally treated this way,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment. Music Credit:...
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“What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, there were a lot of nurses who were skeptical about the need for self-protection. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors,” ONS member Martha Polovich, PhD, RN, AOCN®-Emeritus, adjunct professor in the School of Medicine at the University of Maryland, told Liz Rodriguez, DNP, RN, OCN®, CENP, ONS member and 50th anniversary...
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“We know that some women are going to get called back. And it’s just because usually they can’t see something clearly enough. And so in most cases, those women are going to get cleared with one or two images, and they’re going to say, ‘Oh, we compressed that better, we checked it with an ultrasound, we’re fine.’ That woman can go ahead and go. But we don’t want to miss those early breast cancers,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing...
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"If you take your normal radiation oncology experience, as we know in radiation oncology, radiations are done by the machines, you know, externally. Nurses deal with the side effects and everything like that, whereas radiopharmaceuticals are given kind of on the internal basis, they’re systemic,” ONS member John Hollman, BSN, RN, OCN®, radiation nurse educator for Texas Oncology, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about caring for patients receiving radiopharmaceuticals and theranostics. Music Credit:...
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"In B cell malignancies, BTKi inhibits that BTK enzyme which is very upstream. It tells NF-κB to stop signaling into the nucleus and then inhibits proliferation and survival of B cells," Puja Patel, PharmD, BCOP, clinical oncology pharmacist at Northwestern Medicine Cancer Center at Delnor Hospital in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about BTK inhibitors. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.0 contact hours of...
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“The statistic you always kind of want to keep in the back of your brain is that over a lifetime, one in eight women will be diagnosed with breast cancer. So that means for an individual assigned female at birth, there’s a 13% chance that if that individual lives to age 85, that they will be diagnosed with breast cancer. So, it’s the most common cancer diagnosed in this group,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in St. Louis, MO, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...
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“Who would think that we would be here 50 years later? And with the excitement that I think will build even more, I’m so humbled and honored to talk to young nurses. And their excitement—the same excitement that we had in the very beginning—is inherent. I hope that our legacy will be that we are able to pass on this tremendous gift of our careers to new nurses,” Cindi Cantril, MPH, RN, OCN®-Emeritus, founding ONS member and first vice president, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about the history of...
info_outline“A lot of the efforts have been made to improve the patient experience for these treatments, as they can be given for years at a time. For example, when leuprolide debuted way back in 1985, it was a daily injection. But four years later, they developed the monthly depo formulation. Now we have formulations that are approved for administration once only every three, four, and even six months,” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the luteinizing hormone–releasing hormone (LHRH) antagonist and agonist drug classes.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 9, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
Learning outcome: Learners will report an increase in knowledge related to LHRH antagonists and agonists.
- Episode Notes
- Complete this evaluation for free NCPD.
- Oncology Nursing Podcast episodes:
- Pharmacology 101 series
- Episode 321: Pharmacology 101: CYP17 Inhibitors
- Episode 242: Oncology Pharmacology 2023: Today’s Treatments and Tomorrow’s Breakthroughs
- Episode 154: New Drug Approvals for Metastatic Castration-Sensitive Prostate Cancer
- Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™
- ONS Voice article: Oncology Drug Reference Sheet: Relugolix
- ONS books:
- ONS course: Safe Handling Basics
- ONS Guidelines™ and Symptom Interventions
- ONS Huddle Card: Hormone Therapy
- ONS Learning Libraries:
- Oral Chemotherapy Education Sheets
- National Comprehensive Cancer Network
- On the Treatment of Inoperable Cases of Carcinoma of the Mamma: Suggestions for a New Method of Treatment, With Illustrative Cases (by George T. Beatson)
To discuss the information in this episode with other oncology nurses, visit the ONS Communities.
To find resources for creating an Oncology Nursing Podcast™ Club in your chapter or nursing community, visit the Oncology Nursing Podcast Library.
To provide feedback or otherwise reach ONS about the podcast, email [email protected].
Highlights From This Episode
“Between all of these agonists and antagonists, there’s a broad spectrum of applications, including hormone-positive breast cancer, androgen-deprivation therapy for prostate cancer, uterine cancer, and then other non-cancer uses like uterine fibroids, and assisted reproduction fertility treatments, and other things too.” TS 3:24
“In the education of my female patients, I basically use the analogy that it is functionally inducing menopause in that person, so there can be changes to mood and cognition, energy level fatigue, body morphology, and shifts in fat distribution metabolism, which can unfortunately increase the risk of cardiovascular disease. One that almost everyone’s familiar with is hot flashes, but also changes to bone mineral density, libido and physically to atrophy and dryness of vaginal mucosa, which can make sex for our patients more difficult as well.” TS 10:33
“A concept that’s familiar to all professionals in the care of prostate cancer is that because LHRH agonists cause an initial increase in testosterone, which can, in essence, feed the cancer, some patients can experience worsening symptoms of their cancer, such as difficulty voiding their bladder pain, or even vertebral collapse or spinal cord compression when bone metastases are present. This is a really serious issue that should be considered ahead of starting an agonist in these patients.” TS 12:39
“I don’t think we’ll see any dramatic changes in treating breast cancer, since the role of these agents is a lot more limited and simply really exist to suppress estrogen and premenopausal patients. But as a referral center that routinely sees patients with breast cancer and their 40s and 30s and even their 20s, it’s crucial to consider these agents in their role for not only actively treating certain types of breast cancer, but also in preserving fertility for patients who desire to have children and they are receiving gonadotoxic chemotherapy.” TS 25:32