Joseph Moryousef, Wilhelmina Duivenvoorden, Darryl Leong, Jehonathan H Pinthus
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引用次数: 0
Abstract
Background: The prevalence of cardiovascular risk factors and disease is high in patients with newly diagnosed prostate cancer (PC). Survivorship of PC patients is often determined by cardiovascular disease (CVD). Our review synthesizes the most recent literature exploring the dynamics between PC and CVD across the disease trajectory and treatments. We review key ongoing clinical trials in the field and highlight avenues for future study.
Methods: We conducted a comprehensive narrative review of the literature using various search strategies in three databases (PubMed, Web of Science, ClinicalTrials.gov), focusing on literature published between 2000 and 2024.
Results: We discuss the significance of CVD-related mortality in PC, review the risk factors, and highlight potential mechanisms for accelerated CVD in the androgen-deprivation setting. Furthermore, we summarize key literature of CVD and cardiotoxicity for various therapeutic approaches in PC, including orchiectomy, taxane-based chemotherapy, GnRH-axis targets, and next-generation hormonal agents and PARP inhibitors. Lastly, we discuss prevention strategies and the importance of multi-disciplinary care in this setting.
Conclusion: CVD is a major cause of death in men with PC. Various novel therapeutic approaches have been pivotal in improving oncologic outcomes, but emerging data demonstrate a complex interplay between the androgen axis and CVD that is likely affected by modern treatment strategies. Given the prolonged PC survivorship, unraveling non-oncologic related causes of death and investigating prevention strategies are imperative (Fig. 1). Fig. 1 LANDSCAPE OF PROSTATE CANCER.: Spectrum of prostate cancer disease states (red) and interventions (yellow) with the potential role for optimization (green) to improve cardiovascular outcomes in the future (blue).
背景:在新诊断的前列腺癌(PC)患者中,心血管风险因素和疾病的发病率很高。前列腺癌患者的存活率往往取决于心血管疾病(CVD)。我们的综述综述了最新的文献,这些文献探讨了PC与心血管疾病在整个疾病轨迹和治疗过程中的动态关系。我们回顾了该领域正在进行的主要临床试验,并强调了未来的研究方向:我们在三个数据库(PubMed、Web of Science、ClinicalTrials.gov)中采用不同的搜索策略对文献进行了全面的叙述性综述,重点关注 2000 年至 2024 年间发表的文献:结果:我们讨论了 PC 中心血管疾病相关死亡率的重要性,回顾了风险因素,并强调了雄激素剥夺环境下心血管疾病加速的潜在机制。此外,我们还总结了PC各种治疗方法中心血管疾病和心脏毒性的主要文献,包括睾丸切除术、基于类固醇的化疗、GnRH轴靶点、新一代激素药物和PARP抑制剂。最后,我们讨论了在这种情况下的预防策略和多学科护理的重要性:结论:心血管疾病是 PC 男性患者的主要死因。各种新型治疗方法在改善肿瘤治疗效果方面发挥了关键作用,但新出现的数据表明,雄激素轴与心血管疾病之间存在复杂的相互作用,现代治疗策略可能会对其产生影响。鉴于 PC 患者的生存期较长,揭示与肿瘤无关的死亡原因并研究预防策略势在必行(图 1)。图 1 前列腺癌:前列腺癌疾病状态谱(红色)和干预措施(黄色),以及优化(绿色)对改善未来心血管预后的潜在作用(蓝色)。
期刊介绍:
Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management.
Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis.
Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.