Aims: To prospectively audit a dedicated androgen deprivation (ADT) clinic at a single tertiary centre, focusing on men undergoing ADT for prostate cancer. The audit encompasses treatment duration, prevalence and severity of vasomotor symptoms (VMS), current treatment patterns for symptom management, demographic data, serum testosterone levels, prostate-specific antigen, and liver function tests in patients receiving fezolinetant. Among those receiving pharmacologic therapy for VMS, the use of a written survey to evaluate patient-reported outcomes assessing VMS severity, impact on quality of life, treatment effectiveness, and any adverse effects experienced.
Methods: VASOPRO is an ongoing prospective, observational audit conducted at a dedicated ADT clinic within a single tertiary centre. Men receiving ADT are systematically reviewed for the presence and severity of VMS. For those reporting symptoms warranting treatment, pharmacologic interventions—such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and off-label use of the neurokinin-3 receptor antagonist fezolinetant—are documented. In addition, consenting patients undergoing treatment for VMS complete serial patient-reported outcome surveys to assess symptom burden and therapeutic response over time.
Results: Preliminary data reveal that 61.1% (22 of 36) of men on ADT attending our dedicated clinic report VMS of any severity. Among this symptomatic cohort, 27.3% (6 of 22) are receiving pharmacotherapy for symptom relief. 22.7% (5 of 22) of those receiving treatment are using off-label fezolinetant, reflecting early clinical adoption and potential interest in novel therapeutic options.
Conclusion: VMS are a common and often undertreated adverse effect of ADT in men with prostate cancer. A substantial proportion of affected individuals remain untreated despite symptomatic burden. Off-label use of fezolinetant, although limited, highlights the need for further research into targeted therapies for male VMS. Ongoing data collection from this audit will inform future clinical management strategies and support the development of evidence-based guidelines for this underappreciated aspect of prostate cancer care.