Cardiovascular Toxicity of Androgen Deprivation Therapy.

Julia Boland, William Choi, Maximillian Lee, Jianqing Lin

Current cardiology reports 2021 Jul 03

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Androgen deprivation therapy (ADT) is the standard of care for the treatment of advanced prostate cancer (PC). ADT, particularly with GnRH agonists, leads to increased risk of cardiovascular disease, including myocardial infarction, hypertension, and stroke. This review discusses the options of ADT, the mechanism of ADT-associated cardiovascular side effects, and potential benefit by using GnRH antagonists. GnRH antagonists have relatively less cardiovascular adverse effects compared to GnRH agonists. We highlight on a recently published phase III clinical trial on the oral GnRH antagonist, relugolix, and its comparative benefit to traditional GnRH agonist regarding development of cardiovascular disease. Recent data reinforces that GnRH antagonists have a more favorable cardiovascular outcomes compared to GnRH agonists yet maintain a similar efficacy profile. From the data we reviewed, GnRH antagonists may be the preferred method of ADT for PC, but further data with primary cardiovascular outcomes are warranted.

Citation

Julia Boland, William Choi, Maximillian Lee, Jianqing Lin. Cardiovascular Toxicity of Androgen Deprivation Therapy. Current cardiology reports. 2021 Jul 03;23(8):109