PMID- 29797220
OWN - NLM
STAT- MEDLINE
DCOM- 20180806
LR  - 20181114
IS  - 1432-1335 (Electronic)
IS  - 0171-5216 (Linking)
VI  - 144
IP  - 9
DP  - 2018 Sep
TI  - Effectiveness and tolerability of targeted drugs for the treatment of metastatic 
      castration-resistant prostate cancer: a network meta-analysis of randomized 
      controlled trials.
PG  - 1751-1768
LID - 10.1007/s00432-018-2664-y [doi]
AB  - PURPOSE: Castration-resistant prostate cancer (CRPC) refers to prostate cancer 
      that has progressed after initial androgen deprivation therapy (ADT). Over the 
      years, treatment strategies for metastatic CRPC (mCRPC) have undergone 
      considerable changes. We performed a network meta-analysis to assess the 
      effectiveness and tolerability of targeted agents for mCRPC. METHODS: We search 
      databases including MEDLINE, EMBASE, and the Cochrane Library through Sep 5, 
      2017. The major effectiveness outcomes were progression-free survival (PFS) and 
      overall survival (OS). The tolerability outcome was severe adverse events (AEs) 
      of grade >/= 3. RESULTS: Twenty-six articles assessing a total of 20,314 patients 
      were included in this study. A random-effect analysis showed that targeted agents 
      could significant prolong PFS in mCRPC patients (I(2) = 94.3%; hazard ratio (HR): 
      0.74; 95% confidence interval (CI): 0.65-0.84; p < 0.001). In addition, the 
      surface under the cumulative ranking curve (SUCRA) ranking from the network 
      analysis showed that enzalutamide was the most effective in improving the PFS of 
      mCRPC patients (100%), followed by abiraterone (90.1%) and tasquinimod (84.2%). 
      Additionally, targeted agents could clearly prolong OS in mCRPC patients 
      (I(2) = 71.6%; HR: 0.91; 95% CI: 0.85-0.97; p < 0.001). Furthermore, based on 
      SUCRA ranking, enzalutamide was the most effective in improving the OS of mCRPC 
      patients (97.2%), followed by abiraterone (91.1%) and zibotentan (65.8%). 
      Intetumumab was associated with the lowest incidence of severe AEs (94.9%), 
      followed by atrasentan (85.1%) and placebo (79.3%). CONCLUSION: In patients with 
      mCRPC, enzalutamide, abiraterone and tasquinimod can prolong PFS, and 
      enzalutamide and abiraterone can prolong OS. Additionally, enzalutamide and 
      abiraterone can improve both PFS and OS with a low risk of causing severe AEs.
FAU - Wang, Yongquan
AU  - Wang Y
AD  - Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan 
      Street, Shapingba District, Chongqing, 400038, China.
FAU - Zhang, Heng
AU  - Zhang H
AD  - Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan 
      Street, Shapingba District, Chongqing, 400038, China.
FAU - Shen, Wenhao
AU  - Shen W
AD  - Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan 
      Street, Shapingba District, Chongqing, 400038, China.
FAU - He, Peng
AU  - He P
AD  - Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan 
      Street, Shapingba District, Chongqing, 400038, China.
FAU - Zhou, Zhansong
AU  - Zhou Z
AUID- ORCID: 0000-0003-2800-6220
AD  - Center of Urology, Southwest hospital Army Medical University, No. 30, Gaotanyan 
      Street, Shapingba District, Chongqing, 400038, China. zhansongzhou96@sina.com.
LA  - eng
GR  - 81000288/The National Natural Science Foundation of China/
GR  - 81270842/The National Natural Science Foundation of China/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20180524
PL  - Germany
TA  - J Cancer Res Clin Oncol
JT  - Journal of cancer research and clinical oncology
JID - 7902060
RN  - 0 (Androstenes)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Quinolones)
RN  - 756U07KN1R (tasquinimod)
RN  - G819A456D0 (abiraterone)
SB  - IM
MH  - Androstenes/therapeutic use
MH  - Antineoplastic Agents/*therapeutic use
MH  - Disease-Free Survival
MH  - Humans
MH  - Male
MH  - Network Meta-Analysis
MH  - Prostatic Neoplasms, Castration-Resistant/*drug therapy
MH  - Quinolones/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Castration-resistant prostate cancer
OT  - Meta-analysis
OT  - Metastatic
OT  - Prostate cancer
OT  - Targeted therapy
EDAT- 2018/05/26 06:00
MHDA- 2018/08/07 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/04/20 00:00 [received]
PHST- 2018/05/08 00:00 [accepted]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/08/07 06:00 [medline]
PHST- 2018/05/26 06:00 [entrez]
AID - 10.1007/s00432-018-2664-y [pii]
AID - 10.1007/s00432-018-2664-y [doi]
PST - ppublish
SO  - J Cancer Res Clin Oncol. 2018 Sep;144(9):1751-1768. doi: 
      10.1007/s00432-018-2664-y. Epub 2018 May 24.