IMPACT-ADT: Mitigating Cardiovascular Risks in Prostate Cancer Care

Описание: In this video, Yun Rose Li, MD, PhD, an assistant professor and physician-scientist from the Department of Radiation Oncology at City of Hope, discussed the clinical background and rationale behind the phase 2 IMPACT-ADT trial (NCT07202247). According to Li, the study was inspired by a specific clinical case where a patient with no traditional risk factors experienced a ST-elevation myocardial infarction (STEMI) shortly after beginning androgen deprivation therapy (ADT). This event highlighted the urgent need for better tools to predict and mitigate cardiovascular risks in patients with prostate cancer.

As prostate cancer survival rates improve, managing competing risks like cardiovascular morbidity has become a priority. Li explained that many acute coronary events occur within the first 6 months of starting ADT, a period that often precedes significant changes in body composition or muscle mass. To address these risks, the IMPACT-ADT trial—supported by the American Heart Association (AHA)—will randomly assign patients into 3 arms: intermittent fasting, GLP-1 receptor agonists such as semaglutide (Ozempic) or tirzepatide (Mounjaro), or the AHA’s “Life’s Essential 8” guidelines.

The inclusion of GLP-1 agonists was driven by their increasing use in standard care and their established cardiovascular benefits. Li addressed concerns regarding muscle wasting and explained how the study will monitor for adverse effects through collaboration with endocrinologists. Additionally, she detailed the intermittent fasting arm, which utilized a 16:8 regimen supported by experienced dietitians. This intervention was chosen for its safety and scalability, offering a low-cost strategy that could potentially be deployed via telehealth to diverse patient populations.

The conversation also touched upon the ongoing debate between LHRH agonists or antagonists and the necessity of long-term monitoring for late-onset risks. By investigating these interventions, the IMPACT-ADT trial aims to provide evidence-based strategies to protect cardiovascular health while maintaining the oncologic benefits of hormonal therapy.

00:00 Introduction/Background for IMPACT-ADT
03:26 Rationale for GLP-1 Selection and AE Monitoring
10:16 Mitigating Sarcopenia Through Adequate Protein Intake While Fasting
13:51 Closing Remarks

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