Association of biomarkers with serious cardiac adverse events during abiraterone acetate treatment in castration resistant prostate cancer

Sara Campora, Eleonora Campazzi, Silvia Zanardi, Matteo Puntoni, Marco Piccininno, Arnoldo Piccardo, Mehrdad Shoushtari Zadeh Naseri, Carlotta Defferrari, Nicoletta Provinciali, Marilena Petrera, Domenico Marra, Ennio Biscaldi, Gian Carlo Antonucci, Damiano Ricci, Matteo Clavarezza, Alessandra Gennari, Alberto Gozza, Mauro D’Amico, Marco Mori, Andrea DeCensi

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: Abiraterone acetate is an effective drug for castration-resistant prostate cancer, but cardiac serious adverse events (SAEs) may occur. We studied their association with N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) during abiraterone therapy. PATIENTS AND METHODS: In a single institution, 17 patients were treated with abiraterone acetate 1 g daily with concomitant prednisone and then switched to dexametasone plus canrenone. Blood samples for PSA, NT-proBNP, and TnT were obtained at baseline and after 1, 3, and 6 months. RESULTS: Five patients (29.4%) experienced G3 to 4 cardiac SAEs after a median of 13 weeks (range, 9-32), including pulmonary edema, heart failure, acute coronary syndrome, sinus bradycardia with syncope, and pulmonary edema. At baseline, 4 weeks, and 3 months, median NT-proBNP and TnT levels were higher in patients with subsequent cardiac SAEs (P=.03 and P=.04 for NT-proBNP and TnT at 3 months, respectively). After switching to dexametasone and introducing canrenone, no additional cardiac SAEs were noted. Overall response rate was 67%. CONCLUSIONS: Our study suggests a higher than expected risk of cardiac SAEs during abiraterone treatment which may well be due to the small sample size and the unrestricted entry criteria. However, baseline and frequent NT-proBNP and TnT monitoring predicted a higher risk for cardiac SAE. Larger studies should confirm our findings.

Original languageEnglish
Pages (from-to)600-605
Number of pages6
JournalTranslational Oncology
Volume9
Issue number6
DOIs
Publication statusPublished - 1 Dec 2016
Externally publishedYes

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