A practical guide for assessing and managing cardiovascular risk during androgen-deprivation therapy in patients with prostate cancer

Aum J Solanki; Mitchell Kamrava; Edwin M Posadas; Stephen J Freedland; Leslie Ballas; Howard M Sandler; C Noel Bairey Merz; Katelyn M Atkins; Andriana P Nikolova

doi:10.1002/cncr.35285

A practical guide for assessing and managing cardiovascular risk during androgen-deprivation therapy in patients with prostate cancer

Cancer. 2024 Mar 26. doi: 10.1002/cncr.35285. Online ahead of print.

Authors

Aum J Solanki¹, Mitchell Kamrava², Edwin M Posadas³, Stephen J Freedland⁴, Leslie Ballas², Howard M Sandler², C Noel Bairey Merz⁵, Katelyn M Atkins^{2

5}, Andriana P Nikolova⁵

Affiliations

¹ Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
² Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
³ Department of Medicine, Division of Hematology Oncology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
⁴ Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
⁵ Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

PMID: 38529566
DOI: 10.1002/cncr.35285

Abstract

Prostate cancer is the most common malignancy among men worldwide, and androgen-deprivation therapy (ADT) is a mainstay of treatment. There are observational data demonstrating an increased risk of cardiovascular events in patients who receive ADT, particularly those who have an elevated baseline cardiovascular risk. Because, for most patients with prostate cancer, death is predominantly from noncancer-related causes, cardiovascular disease and its risk factors should be optimized during cancer treatment. This review provides an overview of the landscape of ADT treatment and serves as a guide for appropriate cardiovascular screening and risk-mitigation strategies. The authors emphasize the importance of shared communication between the multidisciplinary cancer team and primary care to improve baseline cardiovascular screening and treatment of modifiable risk factors within this higher risk population.

Keywords: androgen‐deprivation therapy; androgen‐receptor antagonists; cardiotoxicity; cardiovascular disease; gonadotropin‐releasing hormone (GnRH) agonists; gonadotropin‐releasing hormone (GnRH) antagonists; prostate cancer.

Publication types

Review