Cardiorespiratory Fitness Reduced With Prolonged ADT in Prostate Cancer

MONDAY, Nov. 30, 2020 — For patients with localized high-risk prostate cancer (PC), prolonged androgen deprivation therapy (ADT) is associated with reduced cardiorespiratory fitness (CRF) and increased cardiovascular (CV) mortality, according to a study published in the Nov. 1 issue of JACC: CardioOncology.

Jingyi Gong, M.D., from Brigham and Women’s Hospital in Boston, and colleagues compared CRF and CV mortality among patients with PC with and without ADT exposure. Data were included for 616 patients who underwent exercise treadmill testing (ETT) a median of 4.8 years after PC diagnosis; 150 (24.3 percent) received ADT prior to ETT, including 99 and 51 with short-term and prolonged exposure, respectively.

The researchers found that in adjusted analyses, prolonged ADT correlated with reduced CRF (odds ratio, 2.71; 95 percent confidence interval [CI], 1.31 to 5.61; P = 0.007) and increased CV mortality (hazard ratio, 3.87; 95 percent CI, 1.16 to 12.96; P = 0.028). In adjusted Cox regression models, the correlation between short-term ADT exposure and reduced CRF was of borderline significance (odds ratio, 1.71; 95 percent CI, 1.00 to 2.94; P = 0.052), while no correlation was observed with CV mortality (hazard ratio, 1.60; 95 percent CI, 0.51 to 5.01; P = 0.420).

“These findings emphasize the need to consider CV surveillance/risk modification during and after ADT exposure,” a coauthor said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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