Potential Cardiometabolic Risks With Prostate Cancer Treatment


The study is the first cardiovascular outcomes trial to compare two different types of cancer treatment

Chiara Melloni, MD
Chiara Melloni, MD

A DCRI-led study called PRONOUNCE is comparing two types of androgen deprivation therapy (ADT) to determine whether one may lead to less cardio-metabolic risk for patients with atherosclerotic cardiovascular disease (ASCVD) and prostate cancer.

ADT is the mainstay treatment for prostate cancer, but previous research has indicated that it may be associated with cardio-metabolic effects such as increase in total cholesterol and insulin resistance. Previous studies comparing different types of ADT—a gonadotropin-releasing hormone (GnRH) agonist versus a GnRH antagonist—and a meta-analysis of these studies suggests that the antagonist may result in fewer cardiovascular events in this patient population.

PRONOUNCE, a global trial led by DCRI’s Chiara Melloni, MD, and John Alexander, MD, MHS, will provide needed evidence to answer this question by randomizing approximately 900 patients to either an antagonist (degarelix) or an agonist (leuprolide). The primary endpoint is any major adverse cardiovascular event within a year of receiving ADT, including death, heart attack, and stroke.