Influence Of Androgen Suppression Therapy For Prostate Cancer On The Frequency And Timing Of Fatal Myocardial Infarctions

Main Category: Prostate / Prostate Cancer
Also Included In: Cardiovascular / Cardiology;  Men's health;  Clinical Trials / Drug Trials
Article Date: 25 Jun 2007 - 0:00 PDT

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UroToday.com- Recent studies have suggested that patients treated with androgen deprivation therapy for more than 12 months may exhibit nearly a 50% risk of developing the metabolic syndrome. These data have heightened awareness regarding the potential cardiovascular toxicity of luteinizing hormone releasing hormone agonists in men with prostate cancer.

In the June 10th issue of the Journal of Clinical Oncology, D'Amico and colleagues present multi-institutional data evaluating the temporal relationship between androgen deprivation therapy and the risk of developing a fatal myocardial infarction in men with prostate cancer.

The cohort consisted of a total of 1,372 patients pooled from 3 randomized trials designed to evaluate the impact of the duration of ADT on the efficacy of radiotherapy administered for men with prostate cancer. The 3 studies included subgroups of men who had been randomized to receive radiation therapy with no ADT vs. 3 months of ADT, no ADT vs. 6 months of ADT, and 3 vs. 8 months of ADT. Clinical variables were evaluated to determine their association with the risk of a fatal MI.

The investigators found that in men age 65 years or older the use of ADT for 6 months was associated with a higher risk and a shorter time to a fatal MI when compared to men who did not receive ADT. The difference was not seen in men younger than 65 years of age.

These data retrospective obtained from randomized trials add to the growing body of evidence suggesting that androgen deprivation therapy is associated with an increased of the metabolic syndrome which may result in higher cardiovascular mortality. Androgen deprivation therapy is not free of adverse side effects and in older men its use should be limited to those patients with locally advanced or high grade prostate cancer whenever possible.

D'Amico AV, Denham JW, Crook J, Chen MH, Goldhaber SZ, Lamb DS, Joseph D, Tai KH, Malone S, Ludgate C, Steigler A, Kantoff PW

J Clin Oncol. 25(17):2420-5, June 2007
DOI: 10.1200/JCO.2006.09.3369

Reported by UroToday.com Contributing Editor Ricardo F. Sánchez-Ortiz, MD

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