AACR 2019: Abiraterone Acetate and Preexisting Cardiovascular Disease in Patients With Prostate Cancer
Posted: Monday, March 18, 2019
According to Grace Lu-Yao, PhD, MPH, of the Sidney Kimmel Cancer Center at Jefferson, Philadelphia, and colleagues, a higher risk of death was seen after the start of abiraterone acetate treatment in patients with advanced prostate cancer who had a preexisting cardiovascular disease compared with those who did not. In fact, with the increase in hospitalization after initiation of abiraterone acetate, they suggest the need for careful monitoring of patients after prescribing this treatment. These study findings were presented during a media preview of the upcoming 2019 American Association for Cancer Research (AACR) Annual Meeting in Atlanta (Abstract 4469).
“Our data show that patients who have preexisting cardiovascular disease experienced higher mortality after receiving abiraterone acetate compared with those who do not, and the bulk of the survival differences occurred in the first 6 months,” stated Dr. Lu-Yao in an AACR press release. “The increased posttreatment hospitalization rate shows that there is risk associated with abiraterone acetate for all patients.”
Data were collected from patients diagnosed with prostate cancer between January 1, 1991, and December 31, 2013, and treated with abiraterone acetate from 2011 to 2014. Patients’ records came from the Surveillance, Epidemiology, and End Result (SEER)-Medicare database. Of the 2,845 patients analyzed, a total of 1,924 (67.6%) had preexisting cardiovascular disease.
For men without a preexisting cardiovascular disease, 6-month post–abiraterone acetate mortality rose 15.8%. If patients had preexisting cardiovascular disease, it rose from 21.4% with ischemic heart disease to 25.6% with acute myocardial infraction. The hospitalization rate for patients who did not receive chemotherapy and who had no preexisting cardiovascular disease increased by 53%. As for patients with preexisting cardiovascular disease, hospitalization rates increased depending on the condition. For instance, in patients with atrial fibrillation, it increased 34%, whereas in men with acute myocardial infarction, it increased 55%.
Disclosure: Dr. Lu-Yao reported having an immediate family member employed by Sun Pharmaceutical Industries and by Merck. All other study authors reported no conflicts of interest.