Cardiovascular Toxicities of Androgen Deprivation Therapy

Overview

Journal Curr Treat Options Oncol

Specialty Oncology

Date 2021 Apr 18

PMID 33866442

Citations 19

Authors

Azariyas A Challa

Adam Christopher Calaway

Jennifer Cullen

Jorge Garcia

Nihar Desai

Neal L Weintraub

Anita Deswal

Shelby Kutty

Ajay Vallakati

Daniel Addison

Ragavendra Baliga

Courtney M Campbell

Avirup Guha

Affiliations

Soon will be listed here.

Abstract

Prostate cancer is the second leading cause of cancer death in men, and cardiovascular disease is the number one cause of death in patients with prostate cancer. Androgen deprivation therapy, the cornerstone of prostate cancer treatment, has been associated with adverse cardiovascular events. Emerging data supports decreased cardiovascular risk of gonadotropin releasing hormone (GnRH) antagonists compared to agonists. Ongoing clinical trials are assessing the relative safety of different modalities of androgen deprivation therapy. Racial disparities in cardiovascular outcomes in prostate cancer patients are starting to be explored. An intriguing inquiry connects androgen deprivation therapy with reduced risk of COVID-19 infection susceptibility and severity. Recognition of the cardiotoxicity of androgen deprivation therapy and aggressive risk factor modification are crucial for optimal patient care.

Citing Articles

Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients.

Schubel L, Barac A, Magee M, Mete M, Peeples M, Shomali M Contemp Clin Trials Commun. 2025; 43():101387.

PMID: 39810843 PMC: 11732108. DOI: 10.1016/j.conctc.2024.101387.

Salfi G, Pedrani M, Candan S, Urechie V, Merler S, Ruinelli L Eur Urol Open Sci. 2024; 71:1-10.

PMID: 39641119 PMC: 11617314. DOI: 10.1016/j.euros.2024.10.023.

A comprehensive review on the effects of sex hormones on chemotherapy-induced cardiotoxicity: are they lucrative or unprofitable?.

Kheradkhah G, Sheibani M, Kianfar T, Toreyhi Z, Azizi Y Cardiooncology. 2024; 10(1):86.

PMID: 39627907 PMC: 11613924. DOI: 10.1186/s40959-024-00293-3.

The Effect of Androgen Deprivation Therapy on the Cardiovascular System in Advanced Prostate Cancer.

Reiss A, Vasalani S, Albert J, Drewes W, Li K, Srivastava A Medicina (Kaunas). 2024; 60(11).

PMID: 39596912 PMC: 11596556. DOI: 10.3390/medicina60111727.

A systematic review and meta-analysis of cardiovascular disease risk with degarelix and GnRH agonists in prostate cancer.

de Moraes F, Sano V, Dantas C, Hoffmeister N, Kelly F, Burbano R Clin Transl Oncol. 2024; .

PMID: 39500846 DOI: 10.1007/s12094-024-03772-2.

References

Wambier C, Vano-Galvan S, McCoy J, Gomez-Zubiaur A, Herrera S, Hermosa-Gelbard A . Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The "Gabrin sign". J Am Acad Dermatol. 2020; 83(2):680-682. PMC: 7242206. DOI: 10.1016/j.jaad.2020.05.079. View

Abehsira G, Bachelot A, Badilini F, Koehl L, Lebot M, Favet C . Complex Influence of Gonadotropins and Sex Steroid Hormones on QT Interval Duration. J Clin Endocrinol Metab. 2016; 101(7):2776-84. DOI: 10.1210/jc.2016-1877. View

Rehman Y, Rosenberg J . Abiraterone acetate: oral androgen biosynthesis inhibitor for treatment of castration-resistant prostate cancer. Drug Des Devel Ther. 2012; 6:13-8. PMC: 3267518. DOI: 10.2147/DDDT.S15850. View

Thompson I . Flare Associated with LHRH-Agonist Therapy. Rev Urol. 2006; 3 Suppl 3:S10-4. PMC: 1476081. View

Bitting R, Goodman M, George D . Racial Disparity in Response to Prostate Cancer Systemic Therapies. Curr Oncol Rep. 2020; 22(9):96. DOI: 10.1007/s11912-020-00966-z. View

Saigal C, Gore J, Krupski T, Hanley J, Schonlau M, Litwin M . Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer. 2007; 110(7):1493-500. DOI: 10.1002/cncr.22933. View

Lee J, Yousaf A, Fang W, Kolodney M . Male balding is a major risk factor for severe COVID-19. J Am Acad Dermatol. 2020; 83(5):e353-e354. PMC: 7373684. DOI: 10.1016/j.jaad.2020.07.062. View

Ryan C, Smith M, de Bono J, Molina A, Logothetis C, de Souza P . Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2012; 368(2):138-48. PMC: 3683570. DOI: 10.1056/NEJMoa1209096. View

van Poppel H, Nilsson S . Testosterone surge: rationale for gonadotropin-releasing hormone blockers?. Urology. 2008; 71(6):1001-6. DOI: 10.1016/j.urology.2007.12.070. View

10.

Lester-Coll N, Goldhaber S, Sher D, DAmico A . Death from high-risk prostate cancer versus cardiovascular mortality with hormonal therapy: a decision analysis. Cancer. 2013; 119(10):1808-15. DOI: 10.1002/cncr.27980. View

11.

Salem J, Waintraub X, Courtillot C, Shaffer C, Gandjbakhch E, Maupain C . Hypogonadism as a Reversible Cause of Torsades de Pointes in Men. Circulation. 2018; 138(1):110-113. PMC: 6053686. DOI: 10.1161/CIRCULATIONAHA.118.034282. View

12.

Basaria S, Nguyen T, Rosenson R, Dobs A . Effect of methyl testosterone administration on plasma viscosity in postmenopausal women. Clin Endocrinol (Oxf). 2002; 57(2):209-14. DOI: 10.1046/j.1365-2265.2002.01584.x. View

13.

Nguyen P, Je Y, Schutz F, Hoffman K, Hu J, Parekh A . Association of androgen deprivation therapy with cardiovascular death in patients with prostate cancer: a meta-analysis of randomized trials. JAMA. 2011; 306(21):2359-66. DOI: 10.1001/jama.2011.1745. View

14.

Haque R, UlcickasYood M, Xu X, Cassidy-Bushrow A, Tsai H, Keating N . Cardiovascular disease risk and androgen deprivation therapy in patients with localised prostate cancer: a prospective cohort study. Br J Cancer. 2017; 117(8):1233-1240. PMC: 5674100. DOI: 10.1038/bjc.2017.280. View

15.

Sturgeon K, Deng L, Bluethmann S, Zhou S, Trifiletti D, Jiang C . A population-based study of cardiovascular disease mortality risk in US cancer patients. Eur Heart J. 2019; 40(48):3889-3897. PMC: 6925383. DOI: 10.1093/eurheartj/ehz766. View

16.

Tzortzis V, Samarinas M, Zachos I, Oeconomou A, Pisters L, Bargiota A . Adverse effects of androgen deprivation therapy in patients with prostate cancer: focus on metabolic complications. Hormones (Athens). 2017; 16(2):115-123. DOI: 10.14310/horm.2002.1727. View

17.

Hopmans S, Duivenvoorden W, Werstuck G, Klotz L, Pinthus J . GnRH antagonist associates with less adiposity and reduced characteristics of metabolic syndrome and atherosclerosis compared with orchiectomy and GnRH agonist in a preclinical mouse model. Urol Oncol. 2014; 32(8):1126-34. DOI: 10.1016/j.urolonc.2014.06.018. View

18.

DAmico A, Denham J, Crook J, Chen M, Goldhaber S, Lamb D . Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions. J Clin Oncol. 2007; 25(17):2420-5. DOI: 10.1200/JCO.2006.09.3369. View

19.

Quyyumi A . Endothelial function in health and disease: new insights into the genesis of cardiovascular disease. Am J Med. 1998; 105(1A):32S-39S. DOI: 10.1016/s0002-9343(98)00209-5. View

20.

Abufaraj M, Iwata T, Kimura S, Haddad A, Al-Ani H, Abusubaih L . Differential Impact of Gonadotropin-releasing Hormone Antagonist Versus Agonist on Clinical Safety and Oncologic Outcomes on Patients with Metastatic Prostate Cancer: A Meta-analysis of Randomized Controlled Trials. Eur Urol. 2020; 79(1):44-53. DOI: 10.1016/j.eururo.2020.06.002. View