Cardiovascular risk evaluation in men with prostate cancer study (CARE-PC): Pilot study to assess patient awareness and risk mitigation.

Abstract

52 Background: Cardiovascular (CV) disease is a major cause of morbidity and mortality among patients (pts) with prostate cancer (PCa). Shared epidemiologic and androgen-deprivation therapy (ADT)-related factors may contribute to increased CV risk in pts with PCa. As there are limited clinically available tools to educate pts with PCa on CV health risks and CV risk mitigation strategies, CV risk factors are under-recognized and under-treated. We conducted a pilot study to evaluate the feasibility, data quality, and clinical impact of a patient-oriented, web-based application to directly inform PCa pts of their estimated CV risk and CV mitigation strategies (NCT06064149). Methods: Between 11/2023 and 4/2025, PCa patients (< 75 years) currently receiving or planned for ≥ 6 months ADT-based PCa therapy were enrolled. Pts were sent a website link for the CARE-PC application via the electronic medical record (EMR), and self-entered demographic, CV risk factor, CV disease and PCa medical history. Upon completion, CARE-PC immediately provided a personalized CV risk estimate and targeted, guideline-based CV risk reducing education. Primary endpoint was the application completion rate. Secondary endpoints included accuracy of patient-entered data (compared to EMR standard), prevalence of CV risk factors and disease, and cardiologist care access. Results: 82 pts met eligibility. The median age was 66 years, and 20% of pts had localized PCa and 80% had either biochemically recurrent or metastatic PCa. The CARE-PC application completion rate was 54% (44/82). Pts were more likely to complete the web-based tool if age ≥ 65 yrs (61% vs 42%), married (57% vs 46%), Caucasian (62% vs 14% African American), and recurrent or metastatic PCa (59% vs 31% localized PCa). Among 44 pts completing the web tool, 7% (3/44) of pts had diabetes and 61% (27/44) were using antihypertensives (both reported with a 98% (43/44) accuracy rate). 41 pts (93%) accurately reported their CV disease history; 16% (7/44) of pts had a confirmed history of ≥ 1 CV disease. 52% (23/44) of pts were currently followed by a cardiologist. 86% (38/44) accurately reported PCa clinical status (localized vs recurrent or metastatic). 70% (31/44) and 73% (32/44) of pts accurately reported prior PCa therapies and current PCa therapies, respectively. Conclusions: The CARE-PC web-based tool is feasible, but completion rates vary based on age, race, and marital status. Self-entered accuracy of CV risk factor and CV disease was high, with lower accuracy for prior/current PCa therapy. Ongoing analyses will evaluate pt engagement in CV care following CARE-PC participation. Further provider- and patient-oriented quality improvement initiatives are needed to increase awareness and mitigation of competing CV health risks within an individualized PCa clinical context. Clinical trial information: NCT06064149 .