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Title: Cardiovascular disease risk assessment and multidisciplinary care in prostate cancer treatment with ADT: recommendations from the APMA PCCV expert network
Authors: Merseburger, Axel S
Bakshi, Ganesh
Chen, Dong-Yi
Chiong, Edmund
Jabbour, Michel
Joung, Jae Young
Lai, Allen Yu-Hung
Lawrentschuk, Nathan
Le, Tuan-Anh
Ng, Chi Fai
Ng, Choon Ta
Ong, Teng Aik
Pang, Jacob See-Tong
Rabah, Danny M
Ragavan, Narasimhan
Sase, Kazuhiro
Suzuki, Hiroyoshi
Teo, Michelle Mui Hian
Uemura, Hiroji
Woo, Henry H
Affiliations: Faculty of Medicine 
Keywords: Androgen deprivation therapy
Cardiovascular disease
Cardiovascular toxicity
Prostate cancer
Risk management
Issue Date: 2024-03-14
Publisher: National Library of Medicine
Part of: World Journal of Urology
Volume: 42
Issue: 1
Androgen deprivation therapy (ADT) is the mainstay approach for prostate cancer (PCa) management. However, the most commonly used ADT modality, gonadotropin-releasing hormone (GnRH) agonists, has been associated with an increased risk of cardiovascular disease (CVD).

The PCa Cardiovascular (PCCV) Expert Network, consisting of multinational urologists, cardiologists and oncologists with expertise in managing PCa, convened to discuss challenges to routine cardiovascular risk assessment in PCa management, as well as how to mitigate such risks in the current treatment landscape.

The experts identified several barriers, including lack of awareness, time constraints, challenges in implementing risk assessment tools and difficulties in establishing multidisciplinary teams that include cardiologists. The experts subsequently provided practical recommendations to improve cardio-oncology care for patients with PCa receiving ADT, such as simplifying cardiovascular risk assessment, individualising treatment based on CVD risk categories, establishing multidisciplinary teams and referral networks and fostering active patient engagement. A streamlined cardiovascular risk-stratification tool and a referral/management guide were developed for seamless integration into urologists’ practices and presented herein. The PCCV Expert Network agreed that currently available evidence indicates that GnRH antagonists are associated with a lower risk of CVD than that of GnRH agonists and that GnRH antagonists are preferred for patients with PCa and a high CVD risk.

In summary, this article provides insights and guidance to improve management for patients with PCa undergoing ADT.
ISSN: 07244983
DOI: 10.1007/s00345-024-04852-2
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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