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  ["project_title"]=>
  string(131) "Blood pressure during androgen-pathway inhibition in prostate cancer: components, mechanism, and a test of the ESC withholding rule"
  ["project_narrative_summary"]=>
  string(842) "Men with advanced prostate cancer are treated with hormone therapy that often raises blood pressure. Guidelines list these treatments as a cause of high blood pressure but do not say how much they raise it, and they group together drugs that work in very different ways. Abiraterone is always given with a steroid, so it has never been clear whether the rise comes from abiraterone, from the steroid, or from the hormone therapy itself. European guidance also tells doctors to stop the cancer drug when blood pressure reaches 180/110 and restart below 160/100, but nobody has checked how often that happens. Using the records of 7,424 men from nine randomised trials, we will measure how much each part raises blood pressure, whether changes in blood potassium show that the parts act differently, and how often the stopping rule would apply."
  ["project_learn_source"]=>
  string(10) "web_search"
  ["principal_investigator"]=>
  array(7) {
    ["first_name"]=>
    string(6) "Xudong"
    ["last_name"]=>
    string(2) "Li"
    ["degree"]=>
    string(2) "MD"
    ["primary_affiliation"]=>
    string(48) "Shanghai Jiao Tong University School of Medicine"
    ["email"]=>
    string(19) "lxd2024@sjtu.edu.cn"
    ["state_or_province"]=>
    string(8) "Shanghai"
    ["country"]=>
    string(5) "China"
  }
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  ["project_ext_grants"]=>
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    ["value"]=>
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    ["label"]=>
    string(68) "No external grants or funds are being used to support this research."
  }
  ["project_date_type"]=>
  string(18) "full_crs_supp_docs"
  ["property_scientific_abstract"]=>
  string(1662) "Background: The 2025 ACC/AHA hypertension guideline lists androgen deprivation therapy (ADT), CYP17 inhibitors and androgen receptor (AR) antagonists among causes of elevated blood pressure (BP) but advises only "avoid or limit use when possible"; the 2024 ESC guideline omits them; the 2022 ESC cardio-oncology guideline sets an operational rule, withholding cancer therapy at 180/110 mmHg and restarting below 160/100 mmHg with consideration of dose reduction. The rule has never been tested against outcomes, no magnitude is attached, and the exposure conflates ADT, CYP17 inhibition, the glucocorticoid accompanying abiraterone, and AR blockade.



Objective: To quantify each component's BP effect, test whether components differ in mechanism, and establish the rule's operating characteristics.



Study Design: IPD meta-analysis across nine randomised trials: anchored comparison, additive component model, rule emulation.



Participants: 7,424 men. LATITUDE and TITAN share an ADT-plus-placebo comparator; COU-AA-301/302 isolate CYP17 inhibition, glucocorticoid constant; SPARTAN isolates AR blockade; ACIS tests additivity; NCT01867710 randomises steroid.



Primary and Secondary Outcome Measures: Co-primary, change in systolic BP to week 24; time to antihypertensive initiation or intensification. Secondary, crossing 180/110, potassium and sodium, cancer outcomes after interruption.



Statistical Analysis: Bayesian component model; MMRM with censoring weights; Fine-Gray models; joint modelling of BP and electrolytes; target trial emulation; standardised to a prespecified population."
  ["project_brief_bg"]=>
  string(3225) "Treatment-induced hypertension is common in advanced prostate cancer, but the guidance available to clinicians is inconsistent and unquantified. The 2025 ACC/AHA hypertension guideline tabulates agents that raise BP. For exposures that can be stopped it gives thresholds: alcohol one drink daily, caffeine below 300 mg daily, oral contraceptives with 20 to 30 mcg ethinyl estradiol. For medicines patients cannot stop, including systemic corticosteroids, angiogenesis inhibitors and "androgen deprivation therapy such as CYP 17 inhibitors or androgen receptor antagonist", the advice is "avoid or limit use when possible" with no magnitude attached. The 2024 ESC hypertension guideline does not mention these agents. The 2022 ESC cardio-oncology guideline takes a different position again, recommending an ACE inhibitor or ARB first line for cancer-therapy-related hypertension and reserving spironolactone for resistant cases.



The exposure described is not one entity. It comprises an ADT backbone, CYP17 inhibition by abiraterone, the glucocorticoid that must accompany abiraterone, and AR blockade by agents such as apalutamide. CYP17 inhibition raises corticotropin and precursor mineralocorticoids, causing sodium retention and potassium loss; the glucocorticoid is given to suppress that pathway but has BP effects of its own; the mechanism of AR-blockade hypertension is unestablished and not thought to be mineralocorticoid-mediated.



Existing evidence stops short of separating these. Aggregate meta-analyses report pooled relative risks for adverse-event-coded hypertension stratified by drug name; the most recent notes among its limitations that the universal co-administration of prednisone "may itself influence blood pressure" and that its between-agent comparisons are exploratory because no participant-level data or formal network analysis were available. A Bayesian network meta-analysis of prostate cancer therapy cardiotoxicity (PROXMAP, 13 trials, 16 292 patients) finds hypertension increased with abiraterone plus prednisone, but uses aggregate event counts and compares regimens rather than components. A randomised open-label phase 2 study (NCT01867710) compared four glucocorticoid regimens with abiraterone and showed that prednisone 5 mg twice daily or dexamethasone 0.5 mg daily avoided mineralocorticoid excess whereas lower prednisone did not; its endpoint was a binary composite within abiraterone-treated men, so it cannot place the glucocorticoid on the same scale as the other components.



What remains unknown is the magnitude in millimetres of mercury, attributable separately to each component, and whether components produce different biochemical phenotypes. Aggregate adverse-event data already suggest a dissociation: in ACIS, adding apalutamide to abiraterone plus prednisone increased hypertension (29.4 versus 24.9 percent) without increasing hypokalaemia (16.1 versus 14.9 percent), whereas in the abiraterone trials both rose together. If measured BP and electrolytes confirm this, the first-line antihypertensive recommended by current guidance may suit one component and not the other. Distinguishing them changes what is prescribed."
  ["project_specific_aims"]=>
  string(1640) "Aim 1. Which strategy raises BP more. Anchored on the ADT-plus-placebo comparator shared by LATITUDE and TITAN, both conducted in metastatic castration-sensitive disease, we will estimate the difference between abiraterone plus prednisone and apalutamide in change in systolic BP, standardised to a prespecified target population. This aim requires no additivity assumption.



Aim 2. Decomposition. An additive component model across the nine trials estimates the BP change attributable separately to CYP17 inhibition, AR blockade, and co-administered glucocorticoid as prednisone-equivalent dose.



Aim 3. Operating characteristics of the 2022 ESC cardio-oncology rule, which directs that cancer therapy be withheld when BP reaches 180/110 mmHg and restarted below 160/100 mmHg with consideration of dose reduction. From BP recorded at every scheduled visit we will estimate how often the rule would fire, in whom and how early, by component; and among men whose study drug was actually interrupted or dose-reduced, whether radiographic progression-free and overall survival were worse.



Aim 4. Mechanism. We hypothesise that CYP17 inhibition raises BP, lowers serum potassium and raises sodium, consistent with mineralocorticoid excess, whereas AR blockade raises BP without these changes. The prespecified falsification test is ACIS, where AR blockade is randomised on constant abiraterone plus prednisone.



Aim 5. Antihypertensive burden and choice: time to initiation or intensification with death competing, and BP trajectory by class first prescribed within component phenotypes."
  ["project_study_design"]=>
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    ["label"]=>
    string(52) "Meta-analysis (analysis of multiple trials together)"
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      ["value"]=>
      string(49) "new_research_question_to_examine_treatment_safety"
      ["label"]=>
      string(49) "New research question to examine treatment safety"
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    [1]=>
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      ["value"]=>
      string(22) "participant_level_data"
      ["label"]=>
      string(36) "Participant-level data meta-analysis"
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      string(37) "participant_level_data_only_from_yoda"
      ["label"]=>
      string(51) "Meta-analysis using only data from the YODA Project"
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  ["project_research_methods"]=>
  string(1236) "All data will be obtained through the YODA Project. Nine trials are requested: NCT01715285 (LATITUDE), NCT02489318 (TITAN), NCT00638690 (COU-AA-301), NCT00887198 (COU-AA-302), NCT01591122, NCT01695135, NCT01946204 (SPARTAN), NCT02257736 (ACIS) and NCT01867710.



Inclusion: all randomised participants in each trial, analysed according to randomised assignment. Exclusion: none at the participant level. Participants without a post-baseline blood pressure remain in time-to-event analyses and contribute to the repeated-measures model under missing at random, with tipping-point sensitivity analysis.



Blood pressure is recorded at every scheduled visit in the posted protocols of SPARTAN, TITAN and ACIS; the other protocols are not posted but will be supplied with the data. If numeric blood pressure is unavailable for a trial, that trial will contribute only to the time-to-antihypertensive and adverse-event outcomes, and this will be stated.



No data from studies outside the YODA Project will be pooled at the participant level. Published aggregate results from trials of other androgen receptor inhibitors may be cited for context in the discussion but will not enter the primary models."
  ["project_main_outcome_measure"]=>
  string(1991) "Co-primary outcomes. (1) Change in seated systolic blood pressure from baseline to week 24, measured after five minutes of rest at scheduled visits as specified in the trial protocols. The estimand is hypothetical with respect to initiation or intensification of antihypertensive therapy, that is, the blood pressure that would have been observed had antihypertensive treatment not been changed. Week 12 is a secondary landmark and all scheduled visits contribute to the longitudinal model. (2) Time from randomisation to first initiation of an antihypertensive medication, or an increase in its dose or in the number of agents, ascertained from concomitant medication records, with death treated as a competing risk. The estimand for this outcome is treatment policy.



Secondary outcomes. Change in diastolic blood pressure. Change in serum potassium and serum sodium, which serve as positive controls for mineralocorticoid excess. Oedema and fluid retention. Investigator-reported hypertension of CTCAE grade 2 or higher and grade 3 or higher. First recorded systolic blood pressure of 180 mmHg or higher, or diastolic of 110 mmHg or higher, which is the trigger of the 2022 ESC cardio-oncology rule. Interruption of study drug or reduction in its dose, with dates. Radiographic progression-free survival and overall survival as adjudicated in each trial. Cardiovascular events as recorded in each trial.



Negative control outcomes. Back pain and nausea, which relate to the underlying disease and to the ADT backbone and have no plausible link to mineralocorticoid signalling; a component effect on either would indicate differential ascertainment rather than a drug effect. Hot flushes are not used as a negative control, because both agents further suppress androgen signalling and published arm-level rates already differ.



Any change to these definitions in the final analysis will be reported explicitly alongside the original specification."
  ["project_main_predictor_indep"]=>
  string(1558) "The main independent variable is randomised treatment assignment, re-expressed as component indicators for each participant-arm.



C1, CYP17 inhibition (abiraterone acetate 1000 mg daily): present in the active arms of COU-AA-301, COU-AA-302, NCT01591122, NCT01695135 and LATITUDE, and in both arms of ACIS and of NCT01867710.



C2, AR blockade (apalutamide 240 mg daily): present in the active arms of SPARTAN, TITAN and ACIS.



C3, glucocorticoid, coded as prednisone-equivalent milligrams per day. COU-AA-301, COU-AA-302 and ACIS give prednisone 5 mg twice daily in both arms, so the randomised contrast in those trials holds glucocorticoid constant and isolates C1 or C2. LATITUDE gives prednisone 5 mg once daily in the active arm while the comparator receives prednisone-matched placebo, so its randomised contrast carries C1 and C3 together. SPARTAN and TITAN use no glucocorticoid in either arm. NCT01867710 randomises four regimens on fixed abiraterone: prednisone 5 mg twice daily, 5 mg once daily, 2.5 mg twice daily, and dexamethasone 0.5 mg once daily, providing a direct randomised contrast for C3.



C4, ADT backbone, is present in all arms of all trials and therefore defines the target population rather than being estimated.



Because assignment to C1, C2 and C3 is randomised within trials, the component contrasts are randomised contrasts, not observational ones. Dose and duration of study drug, and any interruption, are recorded and used to define on-treatment exposure."
  ["project_other_variables_interest"]=>
  string(1035) "Baseline covariates, used for standardisation to the target population and for prespecified effect modification: age; baseline systolic and diastolic BP; number and class of antihypertensive medications at baseline; history of hypertension, ischaemic heart disease, heart failure, stroke, atrial fibrillation; diabetes; estimated glomerular filtration rate; serum potassium and sodium; body mass index; ECOG performance status; disease state (castration-sensitive or castration-resistant) and prior docetaxel; Gleason score; region and race; type of ADT (GnRH agonist, GnRH antagonist, or orchiectomy).



Time-varying variables: blood pressure at each scheduled visit; serum potassium at each scheduled visit; weight; antihypertensive medications with start and stop dates and dose; potassium supplementation; study drug interruption or dose reduction; the date of any oncological progression.



Prespecified effect modifiers: baseline systolic BP, baseline antihypertensive use, age, eGFR, and disease state."
  ["project_stat_analysis_plan"]=>
  string(5107) "Analysis follows a plan registered before data access and is reported in accordance with PRISMA-IPD.



Aim 1. Abiraterone plus prednisone versus apalutamide is estimated by anchored indirect comparison on the ADT-plus-placebo comparator shared by LATITUDE and TITAN. Individual data allow both populations to be standardised to a common target by g-computation rather than assumed exchangeable. The target population is prespecified: metastatic castration-sensitive disease, age about 70, baseline systolic BP near 145 mmHg, one antihypertensive. No additivity assumption is required for this aim.



Component model. A one-stage Bayesian additive component model expresses each arm's effect as the sum of the components present, with trial-level random effects and weakly informative priors. Components are CYP17 inhibition, AR blockade, and glucocorticoid in prednisone-equivalent milligrams per day. All are analysed as randomised. Trial and calendar period are included, because antihypertensive practice changed between 2008 and 2022. A two-stage analysis is reported as sensitivity.



Blood pressure. Change in systolic BP is analysed by mixed models for repeated measures including visit, component indicators, component-by-visit interactions, baseline BP and prespecified covariates, with an unstructured covariance matrix. For the hypothetical estimand, observations after initiation or intensification of antihypertensive therapy are censored and inverse-probability-of-censoring weights applied; the weight model includes BP trajectory, potassium, weight change and pre-event covariates, with stabilised weights truncated at the 1st and 99th percentiles. Because BP trajectory, which drives antihypertensive initiation, is measured at every scheduled visit, censoring is expected to be conditionally independent of the counterfactual outcome; this is examined by varying the weight model. A treatment-policy analysis without censoring is also reported.



Treatment burden. Time to first initiation or intensification is analysed with Fine and Gray subdistribution hazard models with death as a competing risk, with cause-specific Cox as sensitivity. Rates are also reported per 100 person-years, so differences in exposure duration between arms and trials do not drive the comparison.



Guideline rule. The ESC trigger, first systolic BP of 180 mmHg or more or diastolic of 110 mmHg or more at a scheduled visit, is applied to the recorded BP series. Cumulative incidence of triggering is estimated by component with death as a competing risk, and baseline predictors by Fine-Gray regression. Among men who trigger, the consequence of acting on the rule is estimated by target trial emulation: interruption or dose reduction of study drug within 28 days of the trigger versus continuation, using clone-censor-weight methods with time-updated covariates; outcomes are radiographic progression-free survival and overall survival. Because investigators chose whether to interrupt, this is exploratory and limited by the number of triggers.



Mechanism. Effects on systolic BP, potassium and sodium are estimated jointly, allowing correlation within participant and trial. The prespecified hypothesis is that CYP17 inhibition affects all three and AR blockade affects BP only. The prespecified falsification test is ACIS, in which AR blockade is randomised on a constant abiraterone-plus-prednisone background: if adding AR blockade raises BP without lowering potassium, the dissociation is demonstrated within a single randomised comparison. Back pain and nausea serve as negative control outcomes.



Additivity. The model assumes no interaction between components; this is tested by an AR-blockade-by-abiraterone interaction within ACIS and by model fit.



Aim 5. Among participants who develop hypertension, BP trajectory is compared by class of antihypertensive first prescribed, within component-defined phenotype, by clone-censor-weight emulation with time-updated covariates. Spironolactone is not evaluable because the trials excluded men taking it; comparable classes are eplerenone, ACE inhibitors or ARBs, calcium channel blockers and diuretics. Choice was not randomised, so results are hypothesis-generating.



Effect modification. Interactions with prespecified modifiers are estimated within the model; no subgroup is declared positive from its own estimate alone.



Missing data. Multiple imputation by chained equations under missing at random, with delta-adjusted pattern-mixture and tipping-point analyses, as differential dropout is expected where survival differs between arms.



Power. With about 2,280 participants in the CYP17 contrast and 2,260 in the AR contrast and a within-arm SD of 15 mmHg, each component effect should have a 95% interval of about 1.2 mmHg either side, so a 2 mmHg difference is detectable.



Multiplicity. The two co-primary outcomes are ordered hierarchically; secondary outcomes are supportive."
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  ["project_timeline"]=>
  string(1527) "Month 0. Data access granted. The statistical analysis plan is finalised and registered before any data are examined.



Month 1. Data familiarisation and harmonisation across the nine trials: blood pressure at scheduled visits, serum potassium and sodium, concomitant antihypertensive medications with start and stop dates and doses, study drug exposure with interruptions and dose reductions, and baseline covariates. The component design matrix is constructed and a blinded data quality report produced.



Month 2. Primary analyses. Aim 1, the anchored comparison between abiraterone plus prednisone and apalutamide with standardisation to the target population. Aim 2, the additive component model. Aim 3, incidence and predictors of reaching the 180/110 mmHg threshold.



Month 3. Mechanism and remaining analyses. Aim 4, joint modelling of blood pressure with potassium and sodium, and the ACIS falsification test. Aim 5, antihypertensive burden and class. Sensitivity analyses, including the treatment-policy estimand, delta-adjusted pattern-mixture, and the target trial emulation for the guideline rule. Analysis complete.



Month 4. Manuscript drafted and submitted for publication.



Month 5. Results reported back to the YODA Project.



The Data Use Agreement allows access for 12 months. An extension will be requested only if harmonisation of variables across trials conducted between 2008 and 2022 proves more complex than anticipated."
  ["project_dissemination_plan"]=>
  string(966) "The primary manuscript will report the component-specific blood pressure effects, the antihypertensive treatment burden, the mechanistic dissociation between blood pressure and electrolytes, and the operating characteristics of the 2022 ESC cardio-oncology rule on withholding cancer therapy for hypertension.



The intended audience is cardiologists, cardio-oncologists, medical oncologists and urologists who prescribe or manage these therapies, and the committees that write hypertension and cardio-oncology guidelines.



Target journals, in order: JACC CardioOncology; European Heart Journal; Hypertension; European Urology Oncology.



Results will be reported back to the YODA Project on completion and the publication will acknowledge the YODA Project and the data contributor in the form required by the data use agreement. Findings will also be submitted as an abstract to a major cardiology or cardio-oncology meeting."
  ["project_bibliography"]=>
  string(6433) "
1. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.
2. McEvoy JW, Touyz RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J 2024;45:3912-4018.
3. Lyon AR, Lopez-Fernandez T, et al. 2022 ESC Guidelines on cardio-oncology. Eur Heart J 2022;43:4229-4361.
4. Gong Q, Ge F, et al. A systematic review and meta-analysis of treatment-induced hypertension risks from androgen receptor pathway inhibitors in randomized controlled trials for prostate cancer. BMC Cancer 2026. PMID 42271285.
5. El-Taji O, Taktak S, et al. Cardiovascular Events and Androgen Receptor Signaling Inhibitors in Advanced Prostate Cancer: A Systematic Review and Meta-Analysis. JAMA Oncol 2024;10:874-884. PMID 38842801.
6. Cardiovascular events among men with prostate cancer treated with androgen receptor signaling inhibitors: a systematic review, meta-analysis, and network meta-analysis. Prostate Cancer Prostatic Dis 2025. PMID 39237679.
7. Risk of hypertension in cancer patients treated with abiraterone: a meta-analysis. Clin Hypertens 2019. PMID 31168403.
8. Fizazi K, Tran N, et al. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer (LATITUDE). N Engl J Med 2017;377:352-360. PMID 28578607.
9. Chi KN, Agarwal N, et al. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer (TITAN). N Engl J Med 2019;381:13-24.
10. Smith MR, Saad F, et al. Apalutamide Treatment and Metastasis-free Survival in Prostate Cancer (SPARTAN). N Engl J Med 2018;378:1408-1418.
11. de Bono JS, Logothetis CJ, et al. Abiraterone and increased survival in metastatic prostate cancer (COU-AA-301). N Engl J Med 2011;364:1995-2005. PMID 21612468.
12. Ryan CJ, Smith MR, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis. Lancet Oncol 2015;16:152-160. PMID 25601341.
13. Attard G, Merseburger AS, et al. Assessment of the Safety of Glucocorticoid Regimens in Combination With Abiraterone Acetate for Metastatic Castration-Resistant Prostate Cancer: A Randomized, Open-label Phase 2 Study. JAMA Oncol 2019;5:1159-1167.
14. Saad F, Efstathiou E, et al. Apalutamide plus abiraterone acetate and prednisone versus placebo plus abiraterone and prednisone in metastatic, castration-resistant prostate cancer (ACIS). Lancet Oncol 2021;22:1541-1559.
15. Phillippo DM, Dias S, Ades AE, et al. Multilevel network meta-regression for population-adjusted treatment comparisons. J R Stat Soc Ser A 2020;183:1189-1210. PMID 32684669.
16. Phillippo DM, Ades AE, Dias S, et al. Methods for Population-Adjusted Indirect Comparisons in Health Technology Appraisal. Med Decis Making 2018;38:200-211. PMID 28823204.
17. Welton NJ, Caldwell DM, Adamopoulos E, Vedhara K. Mixed treatment comparison meta-analysis of complex interventions: psychological interventions in coronary heart disease. Am J Epidemiol 2009;169:1158-1165.
18. Rucker G, Petropoulou M, Schwarzer G. Network meta-analysis of multicomponent interventions. Biom J 2020;62:808-821.
19. Analysing complex interventions using component network meta-analysis. BMJ 2026. PMID 42134863.
20. Furukawa TA, Suganuma A, et al. Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data. Lancet Psychiatry 2021;8:500-511. PMID 33957075.
21. Brady MC, Ali M, et al. Dosage, Intensity, and Frequency of Language Therapy for Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis. Stroke 2022;53:956-967. PMID 34847708.
22. Carnicelli AP, Hong H, et al. Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation: Patient-Level Network Meta-Analyses of Randomized Clinical Trials With Interaction Testing by Age and Sex. Circulation 2022;145:242-255. PMID 34985309.
23. ICH E9(R1) addendum on estimands and sensitivity analysis in clinical trials. 2019.
24. Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 1999;94:496-509.
25. Hernan MA, Robins JM. Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available. Am J Epidemiol 2016;183:758-764.
26. Auchus RJ. The genetics, pathophysiology, and management of 17-hydroxylase deficiency and the mineralocorticoid consequences of CYP17 blockade.
27. Attard G, Reid AH, et al. Selective inhibition of CYP17 with abiraterone acetate is highly active in the treatment of castration-resistant prostate cancer. J Clin Oncol 2009;27:3742-3748.
28. Consequences of Different Corticosteroids on Serum Potassium and Prostate-Specific Antigen in Patients Receiving Abiraterone for Castration-Resistant Prostate Cancer. Clin Med Insights Oncol 2017. PMID 29118587.
34. Lyon AR, Lopez-Fernandez T, et al. 2022 ESC Guidelines on cardio-oncology, Section 6.5 Arterial hypertension: cancer therapy should be deferred or temporarily withheld above 180/110 mmHg until BP is below 160/100 mmHg. Eur Heart J 2022;43:4229-4361.
35. Cardiac Safety of Reduced Cardiotoxicity Surveillance During HER2-Targeted Therapy. JACC CardioOncol 2025. PMID 40537192.
36. Cardiovascular Considerations During Cancer Therapy: Gaps in Evidence and JACC: CardioOncology Expert Panel Recommendations. JACC CardioOncol 2024. PMID 39801647.
32. Attard G, Merseburger AS, Arlt W, et al. Assessment of the Safety of Glucocorticoid Regimens in Combination With Abiraterone Acetate for Metastatic Castration-Resistant Prostate Cancer: A Randomized, Open-label Phase 2 Study. JAMA Oncol 2019;5:1159-1167. PMID 31246234.
33. Prostate Cancer Therapy Cardiotoxicity Map (PROXMAP) for Advanced Disease States: A Systematic Review and Network Meta-analysis with Bayesian Modeling of Treatment Histories. Eur Urol 2025. PMID 39299896.
29. Stewart LA, Clarke M, Rovers M, et al. Preferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data: the PRISMA-IPD Statement. JAMA 2015;313:1657-1665.
30. Hughes DA, Bujkiewicz S, Dias S, et al. Methodological recommendations for the use of individual participant data in network meta-analysis. Res Synth Methods.
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