Cardiovascular Toxicity Associated With Androgen Receptor Axis-Targeted Agents in Patients With Prostate Cancer: A Meta-analysis of Randomized Controlled Trials.
Clin Genitourin Cancer
; 22(3): 102066, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38584004
ABSTRACT
INTRODUCTION:
Second-generation androgen receptor axis-targeting (ARAT) agents have become a standard treatment for patients with advanced prostate cancer (PC), however much remains unknown about the potential cardiovascular toxicities. PATIENTS ANDMETHODS:
We performed a systematic search of PubMed, Embase, Web of Science, and Cochrane library for randomized controlled trials of patients receiving ARAT agents for PC from inception to March 2023. The odds ratios (ORs) of all-grade and high-grade cardiovascular adverse events (CVAEs) for patients treated with and without ARAT agents were pooled for meta-analysis. Subgroup analyses based on PC type and treatment regimen were conducted.RESULTS:
A total of 15 double-blind placebo-controlled phase 3 trials comprising 15,842 patients were included. In addition to hot flush and hypertension of any degree of severity, inclusion of ARAT agents was associated with a significantly higher risk of acute myocardial infarction (OR 1.96, 95% CI 1.05-3.68, P = .04), myocardial infarction (OR 2.44, 95% CI 1.27-4.66, P = .007) and angina pectoris (OR 2.00, 95% CI 1.00-4.02, P = .05). With regard to individual ARAT agents, enzalutamide was associated with a significantly higher risk of acute myocardial infarction (OR 3.11, 95% CI 1.17-8.28, P = .02), coronary artery disease (OR 8.33, 95% CI 1.54-44.95, P = .01), and high-grade hypertension (OR 4.94, 95% CI 1.11-22.06, P = .04), while abiraterone and apalutamide were associated with a significantly higher risk of angina pectoris (OR 5.48, 95% CI 1.23-24.33, P = .03) and myocardial infarction (OR 7.00, 95% CI 1.60-30.62, P = .01), respectively.CONCLUSION:
The inclusion of ARAT agents was associated with a significantly higher risk of several CVAEs. Clinicians should remain vigilant, both in pre-treatment screening and monitoring for clinical symptoms and signs, when considering ARAT agent particularly for patients with pre-existing risk factors.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
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Ensaios Clínicos Controlados Aleatórios como Assunto
Limite:
Humans
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Male
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article