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Review
. 2016 Dec;9(6):600-605.
doi: 10.1016/j.tranon.2016.08.001.

Association of Biomarkers with Serious Cardiac Adverse Events during Abiraterone Acetate Treatment in Castration Resistant Prostate Cancer

Sara Campora  1 , Eleonora Campazzi  2 , Silvia Zanardi  2 , Matteo Puntoni  3 , Marco Piccininno  4 , Arnoldo Piccardo  5 , Mehrdad Shoushtari Zadeh Naseri  5 , Carlotta Defferrari  2 , Nicoletta Provinciali  2 , Marilena Petrera  2 , Domenico Marra  2 , Ennio Biscaldi  6 , Gian Carlo Antonucci  7 , Damiano Ricci  4 , Matteo Clavarezza  2 , Alessandra Gennari  2 , Alberto Gozza  2 , Mauro D'Amico  2 , Marco Mori  8 , Andrea DeCensi  2
Affiliations
Review

Association of Biomarkers with Serious Cardiac Adverse Events during Abiraterone Acetate Treatment in Castration Resistant Prostate Cancer

Sara Campora et al. Transl Oncol. 2016 Dec.

Abstract

Background: Abiraterone acetate is an effective drug for castration-resistant prostate cancer, but cardiac serious adverse events (SAEs) may occur. We studied their association with N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) during abiraterone therapy.

Patients and methods: In a single institution, 17 patients were treated with abiraterone acetate 1 g daily with concomitant prednisone and then switched to dexametasone plus canrenone. Blood samples for PSA, NT-proBNP, and TnT were obtained at baseline and after 1, 3, and 6 months.

Results: Five patients (29.4%) experienced G3 to 4 cardiac SAEs after a median of 13 weeks (range, 9-32), including pulmonary edema, heart failure, acute coronary syndrome, sinus bradycardia with syncope, and pulmonary edema. At baseline, 4 weeks, and 3 months, median NT-proBNP and TnT levels were higher in patients with subsequent cardiac SAEs (P= .03 and P= .04 for NT-proBNP and TnT at 3 months, respectively). After switching to dexametasone and introducing canrenone, no additional cardiac SAEs were noted. Overall response rate was 67%.

Conclusions: Our study suggests a higher than expected risk of cardiac SAEs during abiraterone treatment which may well be due to the small sample size and the unrestricted entry criteria. However, baseline and frequent NT-proBNP and TnT monitoring predicted a higher risk for cardiac SAE. Larger studies should confirm our findings.

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Figures

Figure 1
Figure 1
Box plots of the changes of NT-proBNP (A) and TnT (B) during abiraterone acetate treatment according to the subsequent occurrence of a cardiac SAEs.
Figure 2
Figure 2
Box plots of the changes of PSA (difference 0-12 weeks) according to NT-proBNP median level at baseline.
See this image and copyright information in PMC

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