Comorbid CVD May Up Mortality With ADT for Prostate Cancer

Elderly prostate cancer patients with preexisting cardiovascular diseases (CVDs) using abiraterone acetate (AA) or enzalutamide (ENZ) have higher short-term mortality compared with their counterparts without CVDs, according to a study published online Aug. 13 in European Urology.

Grace Lu-Yao, Ph.D., M.P.H., from the Sidney Kimmel Cancer Center at Jefferson in Philadelphia, and colleagues examined the short-term outcomes of AA and ENZ in patients by preexisting CVDs in a population-based retrospective study.

The researchers found that 67 percent of the eligible patients (2,845 with AA and 1,031 with ENZ) had at least one preexisting CVD. Those with one or two preexisting CVDs had higher six-month mortality compared with those without preexisting CVDs (relative risk, 1.16; 95 percent confidence interval, 1.00 to 1.36); the risk was further increased among those with three or more preexisting CVDs (relative risk, 1.56; 95 percent confidence interval, 1.29 to 1.88). Most of the differences in survival according to preexisting CVD condition occurred within the first six months of treatment.

"For prostate cancer patients to receive these medications, assessment of CVD risk and/or comorbidities is vital to help inform treatment decision-making," the authors write. "Further studies are warranted to understand the potential mechanisms and to develop appropriate guidelines to manage this significant subset of men with advanced prostate cancer and comorbidities."

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