Yoshiyuki Miyaji, Shinjiro Shimizu, Michihiro Sato
{"title":"Darolutamide致老年M0去势抵抗性前列腺癌心衰1例","authors":"Yoshiyuki Miyaji, Shinjiro Shimizu, Michihiro Sato","doi":"10.1002/iju5.70068","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Androgen receptor signaling inhibitors (ARSIs) improve survival in prostate cancer; however, it may increase cardiovascular risks, especially in elderly patients with heart disease.</p>\n </section>\n \n <section>\n \n <h3> Case Presentation</h3>\n \n <p>A 94-year-old man with aortic valve stenosis, hypertension, and diabetes had a nodal metastatic progression of prostate cancer at 88 years of age, leading to the implementation of androgen deprivation therapy (ADT). After 5 years of therapy, prostate-specific antigen (PSA) re-elevated; however, ADT was maintained. At 94 years old, darolutamide was started due to worsening of urinary symptoms. Although these symptoms improved, the patient developed a heart failure with elevated B-type natriuretic peptide (BNP). Darolutamide was discontinued, leading to reduced BNP levels but increased PSA levels. A reduced dose (300 mg/day) resulted in stable PSA levels without BNP elevation.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Careful cardiovascular monitoring is crucial when ARSIs are used in older patients with heart disease. Dose adjustments may help balance oncological benefits and cardiac safety.</p>\n </section>\n </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"466-469"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70068","citationCount":"0","resultStr":"{\"title\":\"Heart Failure Induced by Darolutamide in an Older Patient With M0 Castration-Resistant Prostate Cancer: A Case Report\",\"authors\":\"Yoshiyuki Miyaji, Shinjiro Shimizu, Michihiro Sato\",\"doi\":\"10.1002/iju5.70068\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Androgen receptor signaling inhibitors (ARSIs) improve survival in prostate cancer; however, it may increase cardiovascular risks, especially in elderly patients with heart disease.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Case Presentation</h3>\\n \\n <p>A 94-year-old man with aortic valve stenosis, hypertension, and diabetes had a nodal metastatic progression of prostate cancer at 88 years of age, leading to the implementation of androgen deprivation therapy (ADT). After 5 years of therapy, prostate-specific antigen (PSA) re-elevated; however, ADT was maintained. At 94 years old, darolutamide was started due to worsening of urinary symptoms. Although these symptoms improved, the patient developed a heart failure with elevated B-type natriuretic peptide (BNP). Darolutamide was discontinued, leading to reduced BNP levels but increased PSA levels. A reduced dose (300 mg/day) resulted in stable PSA levels without BNP elevation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Careful cardiovascular monitoring is crucial when ARSIs are used in older patients with heart disease. Dose adjustments may help balance oncological benefits and cardiac safety.</p>\\n </section>\\n </div>\",\"PeriodicalId\":52909,\"journal\":{\"name\":\"IJU Case Reports\",\"volume\":\"8 5\",\"pages\":\"466-469\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70068\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJU Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/iju5.70068\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJU Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/iju5.70068","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Heart Failure Induced by Darolutamide in an Older Patient With M0 Castration-Resistant Prostate Cancer: A Case Report
Introduction
Androgen receptor signaling inhibitors (ARSIs) improve survival in prostate cancer; however, it may increase cardiovascular risks, especially in elderly patients with heart disease.
Case Presentation
A 94-year-old man with aortic valve stenosis, hypertension, and diabetes had a nodal metastatic progression of prostate cancer at 88 years of age, leading to the implementation of androgen deprivation therapy (ADT). After 5 years of therapy, prostate-specific antigen (PSA) re-elevated; however, ADT was maintained. At 94 years old, darolutamide was started due to worsening of urinary symptoms. Although these symptoms improved, the patient developed a heart failure with elevated B-type natriuretic peptide (BNP). Darolutamide was discontinued, leading to reduced BNP levels but increased PSA levels. A reduced dose (300 mg/day) resulted in stable PSA levels without BNP elevation.
Conclusion
Careful cardiovascular monitoring is crucial when ARSIs are used in older patients with heart disease. Dose adjustments may help balance oncological benefits and cardiac safety.
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