CV CARE: Cardiovascular care of androgen-related effects in prostate cancer patients.

Abstract

e13581 Background: Cardiovascular disease (CVD) is a leading cause of death among prostate cancer (PC) survivors, and treatment with androgen deprivation therapy (ADT) negatively impacts metabolic factors and CVD risk. A standardized approach to delivering patient education regarding CVD risk remains a major unmet need. To address this, we implemented CV CARE (CardioVascular Care of Androgen Related Effects) to assess the feasibility of delivering advanced practice provider (APP)-driven personalized CV risk assessment and patient education in an oncology clinic at ADT initiation. Methods: Patients with PC receiving ≥ 24 weeks of ADT were enrolled in a DFCI IRB approved study within 12 weeks of starting ADT. CV risk labs (lipid panel, HbgA1c) were collected at enrollment, and patients received education from APPs at study start and 24 weeks later. Atherosclerotic Cardiovascular Disease (ASCVD) risk scores were calculated to determine personalized CVD risk, and the ABCDE (Awareness, Blood pressure, Cholesterol/Cigarette cessation, Diabetes/Diet, and Exercise) algorithm was used to educate on reversible CVD risk factors. Patients identified as high risk (ASCVD score of > 20%) were referred to cardio-oncology. Lipid levels, HgbA1c, ASCVD risk, and ADT effects were communicated via electronic medical record to patients’ care teams. Following study completion, patients and APPs were interviewed to provide feedback that will be used to revise the program. The primary endpoint is the feasibility of integrating the revised CV CARE program into the clinic workflow, as determined by continued participation rates (if ≥75% of patients remain in the program at week 24). Secondary endpoints include medication changes between ADT initiation and week 24, and clinician and patient reported satisfaction. Results: In total, 60 patients were enrolled into CV CARE (Table 1). 43.3% (26) completed the study, and 26.7% (16) remain in follow-up. Qualitative interviews assessing clinician and patient satisfaction with CV CARE are ongoing. Conclusions: We have completed enrollment in a study to explore the feasibility of integrating APP-delivered CVD risk assessment, patient education, and standardized multi-disciplinary communication for PC patients starting ADT. Ongoing assessments include feasibility, clinician and patient satisfaction, and changes in CVD-associated medications. This study was approved and funded by the National Comprehensive Cancer Network (NCCN) Oncology Research Program (ORP) from general research support provided by Pfizer Inc. and Sumitomo Pharma America, Inc. Clinical trial information: NCT06202820 . Baseline patient characteristics. Characteristics Overall N=60 (%) Age, Median, IQR 69 (64-73) Ethnicity (non-Hispanic) 95% (57) Localized Disease 70% (42) Current or Former Smoker 30% (18) Patients on Anti-HTN Medication 58.3% (35) Patients on Statin Medication 61.7% (37) Hypertension 71.7% (43) Hyperlipidemia 70% (42) Diabetes 20% (12)