Cardiovascular risks and toxicity - The Achilles heel of androgen deprivation therapy in prostate cancer patients

Sakthivel Muniyan, Lei Xi, Kaustubh Datta, Anindita Das, Benjamin A. Teply, Surinder K. Batra, Rakesh C. Kukreja

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


Androgen deprivation therapy (ADT) is the primary systemic therapy for treating locally advanced or metastatic prostate cancer (PCa). Despite its positive effect on PCa patient survival, ADT causes various adverse effects, including increased cardiovascular risk factors and cardiotoxicity. Lifespans extension, early use of ADT, and second-line treatment with next-generation androgen receptor pathway inhibitors would further extend the duration of ADT and possibly increase the risk of ADT-induced cardiotoxicity. Meanwhile, information on the molecular mechanisms underlying ADT-induced cardiotoxicity and measures to prevent it is limited, mainly due to the lack of specifically designed preclinical studies and clinical trials. This review article compiles up-to-date evidence obtained from observational studies and clinical trials, in order to gain new insights for deciphering the association between ADT use and cardiotoxicity. In addition, potential cardioprotective strategies involving GnRH receptors and second messenger cGMP are discussed.

Original languageEnglish (US)
Article number188383
JournalBiochimica et Biophysica Acta - Reviews on Cancer
Issue number1
StatePublished - Aug 2020


  • Androgen deprivation therapy
  • Cardiotoxicity
  • GnRH agonists
  • Prostate cancer
  • Sildenafil citrate
  • cGMP

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research


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