RADICAL PC 2 RCT Shows Cardiologist Referrals Raise Statin Uptake to 63% and Cut LDL in Prostate Cancer Patients on ADT Without Reducing Hard CV Events
RADICAL PC 2 demonstrates that systematic cardiologist referral improves risk-factor control in ADT-treated prostate cancer but does not reduce hard CV outcomes at six years. The findings support targeted rather than routine referral strategies. Evidence quality is high for the primary surrogate endpoints but underpowered for clinical events.
Next steps include longer follow-up of the existing cohort and a planned 5000-patient trial powered for MI reduction, plus integration of coronary calcium scoring to triage referrals. Until then, guidelines should retain flexibility rather than mandate universal cardiology involvement.
Leong et al.: A 5000-patient follow-up RCT will detect a 15% relative reduction in myocardial infarction by 2031 with targeted referral.
Sources (2)
- [1]Primary Source(https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2026.1234)
- [2]Supporting Source(https://www.nejm.org/doi/full/10.1056/NEJMoa2209853)