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2022 Joel Holsinger – PCF Young Investigator Award

Biomarker-Based Approaches to Understand and Predict Cardiovascular Toxicity from Androgen Deprivation Therapy in Patients with Prostate Cancer

Sagar Patel, MD
Emory University

Mentors: Martin Sanda, MD, Ashesh Jani, MD, Arthur Stillman, MD, PhD

Description:

  • Cardiovascular (CV) mortality is a leading cause of death in patients with prostate cancer.
  • Androgen deprivation therapy (ADT), a mainstay treatment for prostate cancer, is associated with increased CV disease risk, and some patients are susceptible to adverse cardiac events within months of initiating ADT. However, the mechanisms by which ADT drives heart disease remains unclear.
  • Multiple studies suggest that CV risk is highest with gonadotropin releasing hormone agonists (e.g. Lupron, one of the most common forms of ADT in the United States), compared with other forms of ADT.
  • Dr. Patel is conducting a randomized clinical trial of prostate cancer patients receiving ADT, to investigate how different forms of androgen-targeting therapies impact inflammation and cardiovascular biology.
  • Cardiac imaging and genomic/immune-based biomarkers associated with CV risk will be evaluated to identify those that can predict which patients are at risk for CV toxicity from ADT.
  • If successful, this project will identify mechanisms underlying CV toxicity from ADT and discover predictive biomarkers that can identify patients at highest risk for CV disease, which can be used to guide treatment and risk-reduction strategies.

What this means to patients: ADT is the primary therapy for advanced and aggressive prostate cancer but may increase risk for CV disease. Dr. Patel and team will investigate how Lupron versus other forms of ADT impact cardiovascular biology and identify biomarkers of CV disease risk. This project will support the development of a precision-based framework to predict CV toxicity from ADT and to inform personalized treatment decisions, such as use of alternative CV risk-reducing androgen-signaling inhibitors or early implementation of survivorship care.