Why the study?
Does androgen deprivation therapy increase the risk of cardiovascular events in patients with metastatic prostate cancer?
Does androgen deprivation therapy increase the risk of cardiovascular events in patients with metastatic prostate cancer?
There is a discrepancy in the literature regarding the cardiovascular risk of ADT in prostate cancer, highlighting the need for studies that account for ADT type and baseline cardiovascular disease.
RCT and meta-analysis results should guide ADT decisions; leaves open effects by ADT type and baseline CVD.
Androgen deprivation therapy (ADT) which remains the first line of therapy for patients with metastatic prostate cancer (PCa) has been associated with metabolic abnormalities and significant risk of cardiovascular disease (CVD) (1). Based on observational studies and two meta-analyses, ADT increases the risk for cardiovascular events but results from randomized clinical trials and relevant subsequent meta-analyses did not confirm those conclusions (1). This literature discrepancy in cardiovascular outcomes in patients on ADT may be associated with lack of evaluation of different types of ADT including gonadotropin-releasing hormone (GnRH) agonists, orchiectomy or anti-androgens, absence of comparison to age-matched patients without PCa, and not assessing pre-existing CVD as a confounding factor.
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Karantanos et al. (2016) studied this question.
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