Predictors of efficacy of androgen-receptor-axis-targeted therapies in patients with metastatic castration-sensitive prostate cancer: A systematic review and meta-analysis.
Androgen Antagonists
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
Castration
Disease-Free Survival
Docetaxel
/ therapeutic use
Humans
Male
Prostatic Neoplasms
/ drug therapy
Prostatic Neoplasms, Castration-Resistant
/ drug therapy
Randomized Controlled Trials as Topic
Treatment Outcome
Abiraterone
Apalutamide
Castration-sensitive prostate cancer
Enzalutamide
Journal
Critical reviews in oncology/hematology
ISSN: 1879-0461
Titre abrégé: Crit Rev Oncol Hematol
Pays: Netherlands
ID NLM: 8916049
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
03
04
2020
revised:
05
05
2020
accepted:
14
05
2020
pubmed:
1
6
2020
medline:
1
7
2020
entrez:
1
6
2020
Statut:
ppublish
Résumé
Both docetaxel and androgen-receptor-axis-targeted (ARAT) agents are approved in metastatic castration-sensitive prostate cancer (mCSPC) patients. Predictive factors of therapy efficacy are lacking. We included articles reporting data about randomized-controlled clinical trials (RCTs) testing an ARAT agent plus ADT vs. ADT. We aimed to obtain pooled estimates of efficacy outcomes and assess differences in pooled estimates of efficacy outcomes between sub-groups. A total of 5427 mCSPC patients enrolled in five RCTs were evaluable for OS (Overall Survival) and PFS (Progression-free survival). Pooled OS-HR (Hazard Ratio) was 0.66 (95 % CI: 0.60-0.74), while pooled PFS-HR was 0.46 (95 % CI: 0.40-0.53). Combined treatment with docetaxel was associated with differential OS outcomes, while tumor volume according to the CHAARTED criteria and visceral metastasis were associated with differential PFS outcomes. Our results add evidence that ARAT agents improve OS in mCSPC and discourage their combined use with docetaxel in this setting.
Sections du résumé
BACKGROUND
BACKGROUND
Both docetaxel and androgen-receptor-axis-targeted (ARAT) agents are approved in metastatic castration-sensitive prostate cancer (mCSPC) patients. Predictive factors of therapy efficacy are lacking.
METHODS
METHODS
We included articles reporting data about randomized-controlled clinical trials (RCTs) testing an ARAT agent plus ADT vs. ADT. We aimed to obtain pooled estimates of efficacy outcomes and assess differences in pooled estimates of efficacy outcomes between sub-groups.
RESULTS
RESULTS
A total of 5427 mCSPC patients enrolled in five RCTs were evaluable for OS (Overall Survival) and PFS (Progression-free survival). Pooled OS-HR (Hazard Ratio) was 0.66 (95 % CI: 0.60-0.74), while pooled PFS-HR was 0.46 (95 % CI: 0.40-0.53). Combined treatment with docetaxel was associated with differential OS outcomes, while tumor volume according to the CHAARTED criteria and visceral metastasis were associated with differential PFS outcomes.
CONCLUSION
CONCLUSIONS
Our results add evidence that ARAT agents improve OS in mCSPC and discourage their combined use with docetaxel in this setting.
Identifiants
pubmed: 32474391
pii: S1040-8428(20)30130-X
doi: 10.1016/j.critrevonc.2020.102992
pii:
doi:
Substances chimiques
Androgen Antagonists
0
Docetaxel
15H5577CQD
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
102992Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.