Conventional prostate cancer medications may be less safe than previously thought

Researchers from Michigan Medicine found that men who took any of the two most common oral medications for advanced prostate cancer, who were also undergoing hormone therapy to treat their disease, were at greater risk for serious metabolic or cardiovascular problems than patients who received only hormone therapy.

Admission of patients abiraterone had a 1.77-fold risk of being admitted to emergency department or hospital due to diabetes, hypertension or heart disease compared to those who were only on hormone therapy. Those receiving enzalutamide were 1.22 times more likely to have these problems.

Compared to patients non-applicants, those who have received an applicant, are also more likely to need an outpatient visit to a doctor for at least one of these state of health. This was not the case when the man was taking enzalutamide.

Abiteran and enzalutamide were found to be relatively safe in clinical trials, but concerns that the population of patients in the trials differed from those in the real world led researchers to look again at the effects of the drugs.

For example, this study analyzed exclusively patients with Medicare health insurance, and most of the men studied were significantly older than those who participated in clinical trial trials.

“Patients in clinical trials tend to be very highly selected and often do not reflect the patient population in their daily practice,” said Lillian J. Lai, MD, researcher at the T32 National Institute of Health in Urological Oncology. Michigan Medicine and the first author of the study. “Trial participants are also undergoing a rigorous safety assessment that some of our patients do not have access to. By studying the side effects in real life, we can better understand the life-threatening risks of these cancer treatments and help clinicians and patients make informed decisions. regarding treatment ”.

Because metabolic and cardiovascular disease tend to be the responsibility of primary care providers, Lai and her fellow authors recommend team care that includes personal caregivers for patients with started prostate cancer as a way to manage these high risks.

“With the further expansion of indications for abiraterone and enzalutamide in the earlier stages of the disease, an increasing number of men will receive these treatments for longer periods of time,” Lai said. “This will potentially increase the number of men affected and increase the risk of adverse events, which will make it important to focus on managing these issues.”

The study was published in JNCI: Journal of the National Cancer Institute.