The findings of a new study published in European Urology show increased short-term mortality after abiraterone acetate (AA) or enzalutamide (ENZ) in patients with pre-existing cardiovascular disease (CVD).
Because elderly patients (≥65 years) with advanced prostate cancer (PCa) and CVD conditions are often excluded from clinical trials of AA or ENZ, little is known about the effects of these medications on these vulnerable patients.
This new population-based retrospective study assessed six-month all-cause mortality in 2,845 patients receiving AA and 1,031 receiving ENZ.
Approximately two-thirds had at least one pre-existing CVD. Compared with those without pre-existing CVDs, having one to two pre-existing CVDs was associated with 16 per cent higher six-month mortality (relative risk [RR] 1.16; 95% CI 1.00-1.36). The risk was increased further among those having three or more CVDs (RR 1.56; 95% CI 1.29-1.88).
Most of the differences in survival occurred within the first six months of treatment.
Mortality associated with CVD did not depend on receiving AA versus ENZ.
The study authors recommend that a multidisciplinary team, including a cardiologist, should evaluate patients with pre-existing CVD in the process of making treatment decisions and monitoring potential side effects.