New Hormonal Agents for Prostate Cancer May Increase Risk of Cardiotoxicity
Significant increase in incidence cardiovascular toxicity in metastatic castration-resistant prostate cancer treated with new hormonal agents.
There is a significant increase in the incidence and relative risk of cardiovascular toxicity in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with new hormonal agents compared with placebo, according to a recent study published in the European Journal of Cancer.
For the retrospective analysis, researchers from the Istituto Europeo di Oncologia, in Milan, Italy, sought to determine the incidence and relative risk of cardiovascular events in patients with mCRPC treated with new hormonal agents like enzalutamide and abiraterone.
They identified six studies that included a total of 6,735 patients to evaluate cardiac toxicity. Results showed that the use of new hormonal agents was associated with an increased risk of all grades of cardiotoxicity (relative risk [RR] = 1.32; 95% CI: 1.08-1.60; P=0.006) versus placebo. There was no significant increase in the risk of grade 3 to 4 cardiac events.
Researchers then analyzed data from 7,830 patients to assess the risk of hypertension with these new hormonal agents.
They found that compared with placebo, the use of new hormonal agents was associated with an increased risk of all-grade hypertension (RR = 1.84; 95% CI: 1.37-2.46; P<0.001) and grade 3 to 4 events (RR = 1.77; 95% CI: 1.13-2.77; P=0.01).
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Researchers found that the incidence of all-grade cardiac toxicity and hypertension increased by 14.8% and 3.7%, respectively, compared with placebo.
The findings suggest that follow-ups for the onset of treatment-related cardiac toxicity should be considered in this patient population.
- Iacovelli R, Verri E, Rocca MC, et al. The incidence and relative risk of cardiovascular toxicity in patients treated with new hormonal agents for castration-resistant prostate cancer. E J Cancer. 2015;15(14):1970-1977.