Key result
GnRH antagonists may be associated with lower rates of cardiovascular events compared to GnRH agonists in prostate cancer patients, particularly those with preexisting cardiovascular disease.
Why the study?
Cardiovascular disease is a common comorbidity in patients with prostate cancer, necessitating review of CV risk associated with androgen deprivation therapy and potential differences between GnRH agonists and antagonists.
Do GnRH antagonists reduce cardiovascular events compared to GnRH agonists in patients with prostate cancer receiving ADT?
Do GnRH antagonists reduce cardiovascular events compared to GnRH agonists in patients with prostate cancer receiving ADT?
In prostate cancer patients receiving androgen deprivation therapy, GnRH antagonists may offer a lower cardiovascular risk profile than agonists, highlighting the importance of baseline cardiovascular risk stratification.
Hypothesis-generating for preferring GnRH antagonists in prostate cancer patients with CVD; randomized trials needed before practice change.
Background: Cardiovascular disease (CVD) is a common comorbidity in patients with prostate cancer. In this review, we summarize the published literature on the association of cardiovascular risk with androgen deprivation therapy (ADT) treatment and explore the potential differences between the gonadotropin-releasing hormone (GnRH) agonists and antagonists and the molecular mechanisms that may be involved. We also provide a practical outlook on the identification of underlying CV risk and explore the different stratification tools available. Results: While not definitive, the current evidence suggests that GnRH antagonists may be associated with lower rates of certain CV events vs agonists, particularly in patients with preexisting CVD. Risk reduction strategies such as lifestyle advice, consideration of ADT modality, and comedications may help to reduce CV risk factors and improve outcomes in prostate cancer patients receiving ADT. Conclusions: Given all the data that is currently available, identification of baseline CV risk factors may be key to risk mitigation in patients with prostate cancer receiving ADT.
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Davey et al. (2022) conducted a review in Prostate cancer. GnRH antagonists vs. GnRH agonists was evaluated on Cardiovascular events. GnRH antagonists may be associated with lower rates of cardiovascular events compared to GnRH agonists in prostate cancer patients, particularly those with preexisting cardiovascular disease.
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