AUA 2017: Early Cardiovascular Morbidity in a Pilot Prospective Randomized Trial Comparing LHRH Agonist and Antagonist Among Patients with Advanced Prostate Cancer.

Boston, MA ( Dr. Pinthus presented on the relationship early cardiovascular morbidity in patients with advanced prostate cancer receiving LHRH agonists and antagonists. Dr. Pinthus and colleagues found interest in this topic because recent data has suggested that LHRH-antagonists may be associated with lower risks of cardiovascular events comparted to LHRH-agonist. They propose that this increased cardiovascular morbidity is associated with an increase in FSH increasing atherosclerosis.

This randomized pilot trial enrolled 23 patients in each arm (one arm being treated with LHRH agonist and the other treated with LHRH antagonist: degarelix). They found six cardiovascular events within the first six months of follow-up in the LHRH agonist arm.
In addition they found the FSH levels decreased significantly in the LHRH-agonist arm compared to degarelix. In addition those with lower FSH decreases in the LHRH-agonist arm (p<0.001) had a 50% increase in the probability of cardiovascular morbidity.

Although this is a small pilot study, there are important implications of the role of FSH and cardiovascular morbidity. With further work in this area there may be increasing evidence against the use of LHRH-agonists resulting in an improved morbidity profile for patients with advanced prostate cancer by using LHRH-antagonists.

Presented By: Jehonathan H. Pinthus, MD, PhD, FRCSC

Written By: Janet Baack Kukreja (@janetkukreja), MD, MPH, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX, Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Department of Urology, UT MD Anderson Cancer Center, Houston TX

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA