In a nutshell
The present study evaluated the effects of hormonal therapy drugs on cardiovascular events in patients with prostate cancer.
Some background
Testosterone (a type of androgen hormone which controls the development and maintenance of male reproductive organs) stimulates the growth of cells in the prostate gland, including prostate cancer cells. Production and release of testosterone is regulated by another hormone named gonadotropin releasing hormone (GnRH) released from the brain. Hormonal therapy such as androgen deprivation therapy (ADT) decreases the amount of testosterone available in the body, thus stopping the growth of prostate cancer cells. Types of ADT are GnRH antagonists (drugs that inhibit GnRH effect, thus stopping the body make testosterone) such as degarelix, or GnRH agonists (drugs similar to GnRH which will stop the secretion of the natural hormone, thus stopping the body make testosterone) such as leuporolide (Eligard). This therapy is commonly suggested to patients with prostate cancer, usually after surgical removal of the prostate gland or radiotherapy. Previous studies have shown that ADT is associated with cardiovascular (CV) disorders that have negative impact on survival of men with low-risk prostate cancer. The present study aimed to evaluate CV risks associated with GnRH agonists versus GnRH antagonists in patients with prostate cancer.
Methods & findings
This study included 2328 men with prostate cancer who were not previously treated with hormonal therapy. Patients were randomly assigned to receive either GnRH agonists for a period of 3, 7, or 12 months (837 patients) or GnRH antagonists for the same periods of time (1491 patients). From each group, 30% of the patients had preexisting CV diseases. CV events such as heart attack, stroke, and thromboembolism (blockade of a blood vessel by a blood clot dislodged from its site of origin) were recorded and compared between the 2 groups. Results showed that men with a CV disease at baseline had a 56% lower risk of a cardiac events or death within 1 year of initiation therapy with GnRH antagonists compared to the group receiving a GnRH agonist.
The bottom line
In summary, this study indicated that GnRH antagonists were associated with less CV events compared to GnRH agonists in patients with prostate cancer and preexisting CV diseases.
The fine print
Other factors such as blood pressure as well as blood sugar and cholesterol blood levels were not monitored during the trials and may have influenced the results.
What’s next?
Consult your physician about androgen deprivation therapy and the most appropriate treatment in your situation.
Published By :
European Urology
Date :
Nov 06, 2013
