title: Association of Biomarkers with Serious Cardiac Adverse Events during Abiraterone Acetate Treatment in Castration Resistant Prostate Cancer.
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.
  
  
  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.
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy. Electronic address: sara.campora@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Campora
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Campazzi
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Zanardi
authors.affiliation: Clinical Trial/Scientific Direction, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Puntoni
authors.affiliation: Cardiology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Piccininno
authors.affiliation: Nuclear Medicine, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Piccardo
authors.affiliation: Nuclear Medicine, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Shoushtari Zadeh Naseri
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Defferrari
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Provinciali
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Marilena
authors.initials: M
authors.lastname: Petrera
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Marra
authors.affiliation: Radiology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Biscaldi
authors.affiliation: Critical Care Medicine, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Antonucci
authors.affiliation: Cardiology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Ricci
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Clavarezza
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gennari
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Gozza
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: D'Amico
authors.affiliation: Laboratory Analysis, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mori
authors.affiliation: Units of Medical Oncology, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: DeCensi