Androgen Deprivation Therapy/Androgen Receptor Signaling Inhibitor Treatments for Prostate Cancer: Pathophysiology and Review of Effects on Cardiovascular Disease

South Med J. 2024 May;117(5):245-253. doi: 10.14423/SMJ.0000000000001687.

Abstract

Androgen deprivation therapy is the cornerstone of systemic management for prostate cancer but is associated with multiple adverse effects that must be considered during treatment. These effects occur because of the profound hypogonadism that is induced from lack of testosterone or due to the medications used in the treatment or in combination with androgen receptor signaling inhibitors. This article critically reviews the associations between androgen deprivation therapy, androgen receptor signaling inhibitors, and cardiovascular complications such as prolonged QT interval, atrial fibrillation, heart failure, atherosclerosis, coronary heart disease, venous thromboembolism, and peripheral arterial occlusive disease. These unfavorable outcomes reinforce the need for regular cardiovascular screening of patients undergoing androgen deprivation for the management of prostate cancer.

MeSH terms

  • Androgen Antagonists* / adverse effects
  • Androgen Antagonists* / therapeutic use
  • Androgen Receptor Antagonists / adverse effects
  • Androgen Receptor Antagonists / therapeutic use
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / prevention & control
  • Humans
  • Hypogonadism / drug therapy
  • Hypogonadism / physiopathology
  • Male
  • Prostatic Neoplasms* / drug therapy
  • Signal Transduction / drug effects

Substances

  • Androgen Antagonists
  • Androgen Receptor Antagonists