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Campora, Sara; Campazzi, Eleonora; Zanardi, Silvia; Puntoni, Matteo; Piccininno, Marco; Piccardo, Arnoldo; Shoushtari Zadeh Naseri, Mehrdad; Defferrari, Carlotta; Provinciali, Nicoletta; Petrera, Marilena; Marra, Domenico; Biscaldi, Ennio; Antonucci, Gian Carlo; Ricci, Damiano; Clavarezza, Matteo; Gennari, Alessandra; Gozza, Alberto; D'Amico, Mauro; Mori, Marco; DeCensi, Andrea
Translational oncology, 12/2016, Volume: 9, Issue: 6Journal Article
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.
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