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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Assessing Cardiovascular Risk of Men with Prostate Cancer on Androgen Deprivation Therapy
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Bertrand Tombal, MD, Ph.D. and Javid Moslehi, MD
Alicia Morgans is Joined by Michael Cookson, Bertrand Tombal and Javid Moslehi in this education program, Contemporary Treatment Strategies For Androgen Deprivation Therapy In Prostate Cancer Discussion, Cardiovascular Risk in Men with Prostate Cancer.
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Cardiovascular Adverse Events and Comorbidity Considerations in Men with Non-Metastatic Prostate Cancer
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Zachary Klaassen, MD, MSc and Chris Wallis, MD, Ph.D.
In this UroToday Journal Club, Christopher Wallis and Zachary Klaassen highlight a recent paper published in Urologic Oncology: Seminars and Original Investigations titled "Androgen receptor inhibitor treatments: Cardiovascular adverse events and comorbidity considerations in patients with non-metastatic prostate cancer".
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Complications of Androgen Deprivation Therapy for Prostate Cancer
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Charles Ryan, MD
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| Alicia Morgans is joined by Charles Ryan discussing the complications associated with ADT treatment in men with prostate cancer as part of this educational initiative contemporary treatment strategies for androgen deprivation therapy in prostate cancer.
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HERO Trial: Oral Relugolix for ADT in Advanced Prostate Cancer
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Thomas Keane, MBBCh, FRCSI, FACS
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| Tom Keane recaps the HERO Phase III Trial comparing the safety and efficacy of relugolix with leuprolide acetate in advanced prostate cancer patients. In this trial, men with advanced prostate cancer who received relugolix achieved rapid, sustained suppression of testosterone levels that were superior to that with leuprolide, with a 54% lower risk of major adverse cardiovascular events.
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| Adverse Effects on the Cardiovascular System in Men with Metastatic Castration-Resistant Prostate Cancer (mCRPC) Treated with Abiraterone or Enzalutamide - Editorial |
| Stephen Freedland, MD |
| Treatments for prostate cancer have rapidly evolved over the past nearly 10 years. Prior to this, the only approved life-prolonging agent for advanced prostate cancer was docetaxel. However, that all changed with the approval of abiraterone and enzalutamide. Both drugs showed profound benefits for men with mCRPC. For these men, survival was measured in months and thus, the long-term toxicity of any therapies was not relevant. Acute toxicities were generally mild and manageable. As such, these agents made a huge impact and became widely used. |
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| Comparison of the Cardiotoxicity of Abiraterone and Enzalutamide in Metastatic Castration-Resistant Prostate Cancer Using Real-World Data |
| Alice Dragomir, MSc, Ph.D. |
| Alice Dragomir presents a real-world analysis of the comparative cardiovascular safety of abiraterone acetate and enzalutamide in patients with mCRPC. In this population-based analysis, patients treated with abiraterone acetate had an increased risk of cardiovascular-related hospitalizations relative to enzalutamide users, in particular for hospitalization for heart failure. |
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| Abiraterone is Associated with Higher Odds of Cardiac Complications Compared to Enzalutamide
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| Eugene Cone, MD
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| In this presented study, Eugene Cone examines the rates of cardiac events for both enzalutamide and abiraterone. These results show an increased cardiac risk with abiraterone and GnRH agonists, which is in line with previous data. In contrast, enzalutamide had no disproportional association with any cardiac adverse events. Despite limitations, the authors concluded that there is an increased risk for cardiac events in patients using GnRH agonists and abiraterone, but not enzalutamide.
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| HERO Phase 3 Trial: Results Comparing Relugolix, an Oral GnRH Receptor Antagonist, vs. Leuprolide Acetate for Advanced Prostate Cancer
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| Neal Shore, MD, FACS
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| Neal Shore presents the HERO Phase III trial assessing the role of relugolix, an oral GnRH receptor antagonist, compared to leuprolide acetate for advanced prostate cancer. All of the primary and key secondary endpoints were achieved in the HERO trial. Ninety-six point seven percent of patients achieved sustained castration through week 48. Relugolix achieved superiority over leuprolide in sustained castration rates, castration and profound castration by day 15, and PSA response by day 15. Relugolix was also superior in achieving better testosterone recovery rates within the normal range (54% vs. 3%) at day 90.
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| Assessment and Management of Cardiovascular Risk Factors Among US Veterans with Prostate Cancer-Initiating Androgen Deprivation Therapy |
| Lova Sun, MD |
| Cardiovascular disease is a leading cause of mortality in patients with prostate cancer. Androgen deprivation therapy (ADT) causes metabolic changes and may increase cardiac risks. It is recommended that cardiovascular risk factors are assessed to mitigate cardiovascular risk factors. In this study, the authors aimed to determine the population-based adherence to screening and management of cardiovascular risk factors in prostate cancer patients, including those undergoing ADT. Lova Sun discusses the results. |
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