TY - JOUR
T1 - The incidence and relative risk of cardiovascular toxicity in patients treated with new hormonal agents for castration-resistant prostate cancer
AU - Iacovelli, Roberto
AU - Verri, Elena
AU - Cossu Rocca, Maria
AU - Aurilio, Gaetano
AU - Cullurà, Daniela
AU - De Cobelli, Ottavio
AU - Nolè, Franco
PY - 2015/6/26
Y1 - 2015/6/26
N2 - Aim New hormonal agents are available for treating metastatic castration-resistant prostate cancer (mCRPC). We aim to define the incidence and relative risk (RR) of cardiovascular events in mCRPC patients treated with these agents. Methods Prospective studies were identified by searching the MEDLINE/PubMed, Cochrane Library and ASCO Meeting abstracts. Combined relative risks (RRs) and 95% confidence intervals (CIs) were calculated using fixed- or random-effects methods. Results We included six articles in this meta-analysis covering a total of 6735 patients who were used to evaluate cardiac toxicity. The use of new hormonal agents was associated with an increased risk of all grades of such toxicity (RR = 1.32, 95% CI, 1.08-1.60; p = 0.006) compared to a placebo, even if the absolute difference in terms of incidence was small at 14.8% versus 11.5%, respectively. No increased risk of grade 3-4 events (RR = 1.35, 95% CI, 0.90-2.03; p = 0.15) was observed. A total of 7830 patients were used to evaluate hypertension, and it was found that the use of new hormonal agents compared to a placebo was associated with an increased risk of all-grades (RR = 1.84, 95% CI, 1.37-2.46; p <0.001) and grade 3-4 events (RR = 1.77, 95% CI, 1.13-2.77; p = 0.01). The absolute incidence was 12.5% versus 7.5% for all-grades and 3.7% versus 2.4% for grade 3-4. Conclusions This analysis revealed a significant increase in the incidence and RR of cardiovascular toxicity in mCRPC treated with new hormonal agents as opposed to a placebo, even though the occurrence of all- and grade 3-4 events rose only 14% and 4%, respectively. Follow-ups for the onset of treatment-related cardiovascular events should therefore be considered in these patients.
AB - Aim New hormonal agents are available for treating metastatic castration-resistant prostate cancer (mCRPC). We aim to define the incidence and relative risk (RR) of cardiovascular events in mCRPC patients treated with these agents. Methods Prospective studies were identified by searching the MEDLINE/PubMed, Cochrane Library and ASCO Meeting abstracts. Combined relative risks (RRs) and 95% confidence intervals (CIs) were calculated using fixed- or random-effects methods. Results We included six articles in this meta-analysis covering a total of 6735 patients who were used to evaluate cardiac toxicity. The use of new hormonal agents was associated with an increased risk of all grades of such toxicity (RR = 1.32, 95% CI, 1.08-1.60; p = 0.006) compared to a placebo, even if the absolute difference in terms of incidence was small at 14.8% versus 11.5%, respectively. No increased risk of grade 3-4 events (RR = 1.35, 95% CI, 0.90-2.03; p = 0.15) was observed. A total of 7830 patients were used to evaluate hypertension, and it was found that the use of new hormonal agents compared to a placebo was associated with an increased risk of all-grades (RR = 1.84, 95% CI, 1.37-2.46; p <0.001) and grade 3-4 events (RR = 1.77, 95% CI, 1.13-2.77; p = 0.01). The absolute incidence was 12.5% versus 7.5% for all-grades and 3.7% versus 2.4% for grade 3-4. Conclusions This analysis revealed a significant increase in the incidence and RR of cardiovascular toxicity in mCRPC treated with new hormonal agents as opposed to a placebo, even though the occurrence of all- and grade 3-4 events rose only 14% and 4%, respectively. Follow-ups for the onset of treatment-related cardiovascular events should therefore be considered in these patients.
KW - Abiraterone acetate
KW - Arterial hypertension
KW - Cardiac toxicity
KW - CRPC
KW - Enzalutamide
KW - Orteronel
KW - Prostate cancer
KW - Safety
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U2 - 10.1016/j.ejca.2015.06.106
DO - 10.1016/j.ejca.2015.06.106
M3 - Article
C2 - 26169016
AN - SCOPUS:84939572850
VL - 51
SP - 1970
EP - 1977
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 14
M1 - 9508
ER -