Hormonal prostate cancer therapies and cardiovascular disease: a systematic review

Heart Fail Rev. 2022 Jan;27(1):119-134. doi: 10.1007/s10741-020-09984-2.

Abstract

Therapeutic intervention for prostate cancer mostly relies on eliminating circulating androgen or antagonizing its effect at the cellular level. As the use of endocrine therapies grows, an under-reported incidence of cardiovascular toxicities occurs in prostate cancer patients. In this review, we summarize data of clinical studies, investigating the cardiovascular and metabolic alterations associated with the use of old and new endocrine drugs (gonadotropin-releasing hormone [GnRH] agonists and antagonists, androgen receptor inhibitors, 17α-hydroxylase/c-17,20-lyase [CYP17] inhibitor) in prostate cancer. To date, studies looking for links between cardiovascular complications and hormone-mediated therapies in prostate cancer have reached conflicting results. Several confounding factors, such as age of patients and related cardiovascular liability, other comorbidities, and use of concomitant drugs, have to be carefully evaluated in future clinical trials. Further research is needed given the continuous advancements being made in prostate cancer treatment.

Keywords: Abiraterone; Androgen deprivation therapy; Cardiovascular disease; Clinical trials; Enzalutamide; Prostate cancer.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Androgen Antagonists / adverse effects
  • Antineoplastic Agents, Hormonal / adverse effects
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Gonadotropin-Releasing Hormone / therapeutic use
  • Humans
  • Male
  • Prostatic Neoplasms* / drug therapy

Substances

  • Androgen Antagonists
  • Antineoplastic Agents, Hormonal
  • Gonadotropin-Releasing Hormone