Table 1 – Incidence of cardiovascular disease per year in prostate cancer patients:
Pinthus then discussed the RADICAL PC1 trial (The role of androgen deprivation therapy in cardiovascular disease – a longitudinal prostate cancer study), which has accrued 1790 patients to date in 15 Canadian sites. There is another study, that sprung from the RADICAL PC1 study, which is the RADICAL PC2 trial (A randomized intervention for cardiovascular and lifestyle risk factors in prostate cancer patients).
The hypothesis of this trial is that ADT is the ‘straw that breaks the camel’s back’, adding significantly to the variety of comorbidities that accompany PC patients, increasing their CVD risk (Figure 1). The objective of RADICAL PC2 is to determine whether systematic CV and lifestyle risk factor modification strategy reduce the risk of CVD in men with a new PC diagnosis who are commencing ADT. There are several risk reductions strategies for CVD (Table 2). Study outcomes will be CV death, MI, stroke, heart failure, arterial revascularization. According to the study protocol, patients will be contacted by telephone at 3, 6 ,12, 18, 24, and 36 months to assess clinical outcomes. The results of this trial are eagerly awaited.
Figure 1 – The role of androgen deprivation therapy in the risk of cardiovascular disease in prostate cancer patients:
Table 2- Risk reduction in the general population for cardiovascular disease:
References:
1. Keating et al. JNCI 2010; 102:39
2. O’farrell, et al. JCO 2015; 102:39
Presented by: Jehonathan Pinthus, MD, Mcmaster University, Canada
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 FOIU 4th Friends of Israel Urological Symposium, July 3-5. 2018, Tel-Aviv, Israel