Androgen deprivation therapy (ADT) is the foundational treatment for metastatic prostate cancer (PCa). Androgen receptor (AR) axis-targeted therapies are a new standard of care for advanced PCa. Although these agents have significantly improved patient survival, the suppression of testosterone is associated with an increased risk of cardiometabolic syndrome. This highlights the urgency of multidisciplinary efforts to address the cardiometabolic risk of anticancer treatment in men with PCa.
Two professional organizations invited five urologists, five clinical oncologists, and two cardiologists to form a consensus panel. They reviewed the relevant literature obtained by searching PubMed for the publication period from April 2013 to April 2023, to address three discussion areas: (i) baseline assessment and screening for risk factors in PCa patients before the initiation of ADT and AR axis-targeted therapies; (ii) follow-up and management of cardiometabolic complications; and (iii) selection of ADT agents among high-risk patients. The panel convened four meetings to discuss and draft consensus statements using a modified Delphi method. Each drafted statement was anonymously voted on by every panelist.
The panel reached a consensus on 18 statements based on recent evidence and expert insights.
These consensus statements serve as a practical recommendation for clinicians in Hong Kong, and possibly the Asia-Pacific region, in the management of cardiometabolic toxicities of ADT or AR axis-targeted therapies in men with PCa.
Frontiers in oncology. 2024 Jan 31*** epublish ***
Darren M C Poon, Guang-Ming Tan, Kuen Chan, Marco T Y Chan, Tim-Wai Chan, Raymond W M Kan, Martin H C Lam, Clarence L H Leung, Kenneth C W Wong, Kevin K H Kam, Chi-Fai Ng, Peter K F Chiu
Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China., Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China., Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR, China., eFLO Urology, Hong Kong, Hong Kong SAR, China., Hong Kong Integrated Oncology Centre, Hong Kong, Hong Kong SAR, China., Department of Surgery, Kwong Wah Hospital, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China., S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.