How to Treat Prostate Cancer With Androgen Deprivation and Minimize Cardiovascular Risk: A Therapeutic Tightrope

Vivek Narayan, Ashley E Ross, Ravi B Parikh, Anju Nohria, Alicia K Morgans, Vivek Narayan, Ashley E Ross, Ravi B Parikh, Anju Nohria, Alicia K Morgans

No abstract available

Keywords: ADT, androgen deprivation therapy; ARSI, androgen receptor signaling agent; CV, cardiovascular; CVD, cardiovascular disease; CVRF, cardiovascular risk factor; GnRH, gonadotropin-releasing hormone; RT, radiation therapy; cancer survivorship; hormonal therapy; mCSPC, metastatic castration-sensitive prostate cancer; prostate cancer; risk factor.

Conflict of interest statement

Dr Narayan has received research support from Bristol-Myers Squibb, Merck, TMunity Therapeutics, Pfizer, and Janssen; and consulting fees from Janssen, Pfizer, Myovant, Amgen, Regeneron, and Merck. Dr Ross has received consulting/speaker fees from Astellas, Bayer, Blue Earth, GenomeDx Biosciences, Janssen, Myovant, and Tempus. Dr Parikh has received grant support from Humana, the National Institutes of Health, the Prostate Cancer Foundation, the National Palliative Care Research Center, the Conquer Cancer Foundation, and the Veterans Administration; received personal fees and equity from GNS Healthcare and Onc.AI; received personal fees from the Cancer Study Group and Nanology; and honorarium from Flatiron and Medscape; and served on the board (unpaid) of the Coalition to Transform Advanced Care. Dr Nohria has received research support from Amgen; and served as a consultant for AstraZeneca, Bantam Pharmaceuticals, Boehringer Ingelheim, and Takeda Oncology. Dr Morgans has received research support from Astellas, Seattle Genetics, Bayer, Sanofi, and Myovant; and consulting fees from Astellas, AstraZeneca, AAA, Bayer, Clovis, Janssen, Dendreon, Myovant, Merck, Exelixis, Novartis, Pfizer, Blue Earth, Myriad, Sanofi, and Lantheus.

Figures

Graphical abstract
Graphical abstract
Figure 1
Figure 1
Cardiometabolic Effects of Androgen Suppression Therapies in Prostate Cancer This figure describes the mechanisms of androgen suppression for commonly used prostate cancer therapies. Adapted with permission from Hahn VS, Zhang KW, Sun L, et al. Circ Res. 2021;128:1576-1593. Cardiometabolic toxicities of androgen suppression are displayed. FSH = follicle-stimulating hormone; GnRH = gonadotropin-releasing hormone; LH = luteinizing hormone.
Figure 2
Figure 2
Factors Influencing Cancer Control, Treatment-Related Toxicity, and Cardiovascular Outcomes This figure describes the competing risks for morbidity and mortality in prostate cancer patients receiving systemic androgen deprivation therapy, including cancer-related, treatment-related, and cardiovascular-related risks. A recommendation is suggested for monitoring and management of cardiovascular risk factors (CVRFs) and cardiovascular disease (CVD). ADT = androgen deprivation therapy; ARSI = androgen receptor signaling agent; BMI = body mass index; BP = blood pressure; GnRH = gonadotropin-releasing hormone; HbA1c = glycosylated hemoglobin.

References

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Source: PubMed

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