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Review
. 2021 Jul 3;23(8):109.
doi: 10.1007/s11886-021-01561-9.

Cardiovascular Toxicity of Androgen Deprivation Therapy

Julia Boland  1 , William Choi  1 , Maximillian Lee  1 , Jianqing Lin  2   3
Affiliations
Review

Cardiovascular Toxicity of Androgen Deprivation Therapy

Julia Boland et al. Curr Cardiol Rep. .

Abstract

Purpose of review: Androgen deprivation therapy (ADT) is the standard of care for the treatment of advanced prostate cancer (PC). ADT, particularly with GnRH agonists, leads to increased risk of cardiovascular disease, including myocardial infarction, hypertension, and stroke. This review discusses the options of ADT, the mechanism of ADT-associated cardiovascular side effects, and potential benefit by using GnRH antagonists.

Recent findings: GnRH antagonists have relatively less cardiovascular adverse effects compared to GnRH agonists. We highlight on a recently published phase III clinical trial on the oral GnRH antagonist, relugolix, and its comparative benefit to traditional GnRH agonist regarding development of cardiovascular disease. Recent data reinforces that GnRH antagonists have a more favorable cardiovascular outcomes compared to GnRH agonists yet maintain a similar efficacy profile. From the data we reviewed, GnRH antagonists may be the preferred method of ADT for PC, but further data with primary cardiovascular outcomes are warranted.

Keywords: Androgen deprivation therapy; Cardio-oncology; Cardiovascular toxicity; Coronary artery disease; GnRH antagonist; Prostate cancer.

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Conflict of interest statement

The authors have no conflict of interest to report.

Figures

Figure 1.
Figure 1.
a Mechanisms of androgen deprivation therapy leading to cardiovascular disease. b Proposed mechanism for plaque instability in men with prostate cancer. TT, testosterone; FSH, follicle-stimulating hormone.
See this image and copyright information in PMC

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