Treatment of Prostate Cancer: ADT and Cardiovascular Risk and Insights from the REVELUTION Study

12 Visioni

Grazie! Condividilo con i tuoi amici!

Non hai gradito questo video. Grazie per il feedback!

Published Apr 26, 2026

Sagar A. Patel, MD, Associate Professor, Winship Cancer Institute, Emory University, Atlanta, Georgia, presents findings from the REVELUTION trial, a randomized study designed to investigate the biologic mechanisms underlying cardiovascular risk associated with androgen deprivation therapy (ADT). He explores whether differences in cardiovascular outcomes between gonadotropin-releasing hormone agonists and antagonists are mediated through atherosclerotic plaque progression.

Using coronary computed tomography angiography, the study evaluates coronary plaque burden before and after treatment initiation. The findings demonstrate greater progression of noncalcified plaque in patients receiving GnRH agonists than in those receiving GnRH antagonists. Noncalcified plaque is identified as a vulnerable subtype associated with cardiovascular events.

Dr. Patel outlines a proposed mechanism involving immune activation through peripheral receptors and potential contributions from follicle-stimulating hormone signaling. These processes may promote macrophage activity and accelerate plaque development in patients receiving agonist therapy.

He addresses clinical implications, including the importance of cardiovascular risk awareness, limitations of current risk stratification tools, and the role of multidisciplinary collaboration. Increased use of antagonist therapy is noted due to rapid testosterone suppression and workflow advantages.

Future research includes the REVELUTION 2 study, which evaluates plaque progression in patients receiving ADT combined with second-generation androgen receptor pathway inhibitors.

Don't forget to join the GRU Community: https://grandroundsinurology.com/register/
Follow us on Twitter/X: https://x.com/GRUrology
And like and subscribe to us here on YouTube!

#ProstateCancer #ADT #CardioOncology #RadiationOncology #Urology