Dr. Slovin on Avoiding ADT-Associated Cardiac Complications in Prostate Cancer

Susan F. Slovin, MD, PhD
Published: Tuesday, Apr 16, 2019



Susan F. Slovin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses ways to avoid androgen deprivation therapy (ADT)-associated cardiac complications in patients with prostate cancer.

There is no easy way to predict which patient is going to experience an ADT-associated cardiac complication or prevent them from happening, explains Slovin. It may be that the creation of a consensus group is needed to explain and voice the issues that providers need to address, she says. Every time a patient starts therapy, their baseline cholesterol and medications should be assessed to determine their risk.

Moreover, a risk nomogram that can discern a patient’s likelihood of sustaining a major cardiovascular event within the next 2 to 5 years if they are taking certain medications would be incredibly valuable to clinicians, adds Slovin. These nomograms would help determine which patients should be given hormonal therapy. This would be very useful, as the clinical trials examining whether or not a GnRH antagonist is better than a GnRH antagonist are not expected to read out for several years. Although retrospective data suggest the superiority of a GnRH agonist, prospective data are needed in order to change practice, she concludes.
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Susan F. Slovin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses ways to avoid androgen deprivation therapy (ADT)-associated cardiac complications in patients with prostate cancer.

There is no easy way to predict which patient is going to experience an ADT-associated cardiac complication or prevent them from happening, explains Slovin. It may be that the creation of a consensus group is needed to explain and voice the issues that providers need to address, she says. Every time a patient starts therapy, their baseline cholesterol and medications should be assessed to determine their risk.

Moreover, a risk nomogram that can discern a patient’s likelihood of sustaining a major cardiovascular event within the next 2 to 5 years if they are taking certain medications would be incredibly valuable to clinicians, adds Slovin. These nomograms would help determine which patients should be given hormonal therapy. This would be very useful, as the clinical trials examining whether or not a GnRH antagonist is better than a GnRH antagonist are not expected to read out for several years. Although retrospective data suggest the superiority of a GnRH agonist, prospective data are needed in order to change practice, she concludes.



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