新一代口服攝護腺癌荷爾蒙治療與心血管疾病
柳瑞明1,2,, 林承家3, 劉冠麟3, 林政鋒3, 莊恆彰1, 吳俊德3
1衛生福利部桃園醫院 泌尿科;2國立陽明大學醫學系;
3長庚醫療財團法人基隆長庚紀念醫院 泌尿科
Androgen Receptor Targeted Agents and Subsequent Risk of Cardiovascular Diseases in Patients with Metastatic Castration-Resistant Prostate Cancer
Jui-Ming Liu1,2, Cheng-Chia Lin3, Kuan-Lin Liu3, Cheng-Feng Lin,3 Heng-Chang Chuang1, Chun-Te Wu3
1Division of Urology, Department of Surgery Taoyuan General Hospital, Ministry of Health and Welfare
2 Department of Medicine, National Yang-Ming University, Taipei, Taiwan
3 Department of Urology, Chang Gung Memorial Hospital, Keelung, Taiwan
Background: To evaluate cardiovascular ischemic complications of androgen receptor targeted agents (ATRAs) in metastatic castration-resistant prostate cancer (mCRPC) treatment.
Methods: This a population-based real-world cohort study of 296 mCRPC patients between 2013 and 2017 using the Chang Gung Research Database (CGRD) of Taiwan. The ATRAs in Taiwan are abiraterone acetate and enzalutamide. The study outcomes are cardiovascular (CV) diseases which included acute coronary syndrome (ACS), stroke, heart failure (HF)
Results: There were 286 patients who received ARTAs and 1535 prostate cancer patients with first-line ADT only in study cohorts. Of the patients who were diagnosed with CV diseases, 9 (2.91%) were ATRAs patients and 36 (2.36%) were first-line ADT users. The mean follow-up period was 10.5 months. The ARTAs group was associated with a significant higher risk of CV diseases (HR, 2.08; 95% CI, 1.21 to 3.57) compared with first-line ADT group. Among them, the risks of ACS (HR, 5.54; 95% CI, 2.17 to 13.59) and HF (HR, 2.50; 95% CI, 1.12 to 5.60) were increased in ARTAs group.
Conclusions: This real-world database study demonstrated that increased risks of CV diseases in patients treated with ARTAs for mCRPC.