PMID- 31993991
OWN - NLM
STAT- MEDLINE
DCOM- 20200727
LR  - 20200727
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Linking)
VI  - 40
IP  - 3
DP  - 2020 Mar
TI  - Systemic Treatment for Metastatic Hormone Sensitive Prostate Cancer: A 
      Comprehensive Meta-Analysis Evaluating Efficacy and Safety in Specific Sub-Groups 
      of Patients.
PG  - 211-226
LID - 10.1007/s40261-020-00888-5 [doi]
AB  - BACKGROUND AND OBJECTIVES: Several systemic treatments are available for 
      metastatic hormone sensitive prostate cancer (mHSPC) including docetaxel (D), 
      abiraterone and prednisone (A + P) and new anti-androgens (NA). In our study we 
      performed a systematic review and meta-analysis assessing efficacy outcomes 
      (survival and radiological-free survival), safety and survival on specific 
      subgroups of patients. METHODS: Outcomes of interest were: (i) Risk of death, 
      biochemical and radiological progression among all patients. (ii) Risk of death 
      according to different pathological/clinical features. (iii) Evaluation of the 
      relative risk (RR) and risk difference of serious toxicity defined as adverse 
      events (AEs) with grade >/= 3 specific AEs. Hazard ratios (HRs) and RR were 
      measures adopted for endpoints 1-3. RESULTS: Overall, eight randomized trials 
      were included in meta-analysis for a total of 9987 patients. Administration of D, 
      A + P and NA resulted in improved overall survival (OS) and radiological 
      progression-free survival (rPFS). Survival benefit was not confirmed in patients 
      receiving NA and previously exposed to docetaxel (HR 0.948, 95% CI 0.671-1.338). 
      Patients with visceral metastases and high lactate dehydrogenase (LDH) did not 
      benefit from NA treatment, while it seems that patients with low Gleason score do 
      not benefit from A + P. NA showed the more favorable safety profile. CONCLUSION: 
      NA may not provide survival benefit when adopted subsequently or in concomitant 
      to D. Specific subgroups of patients may benefit more from A + P, D or NA. Safety 
      profiles significantly differ among agents evaluated.
FAU - Di Nunno, Vincenzo
AU  - Di Nunno V
AD  - Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy.
FAU - Santoni, Matteo
AU  - Santoni M
AD  - Oncology Unit, Macerata Hospital, Macerata, Italy.
FAU - Mollica, Veronica
AU  - Mollica V
AD  - Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy.
FAU - Conti, Alessandro
AU  - Conti A
AD  - Azienda Ospedaliera dell'Alto Adige, Bressanone/Brixen Hospital, Bressanone, 
      Italy.
FAU - Montironi, Rodolfo
AU  - Montironi R
AD  - Section of Pathological Anatomy, Polytechnic University of the Marche Region, 
      School of Medicine, United Hospitals, Ancona, Italy.
FAU - Battelli, Nicola
AU  - Battelli N
AD  - Oncology Unit, Macerata Hospital, Macerata, Italy.
FAU - Ardizzoni, Andrea
AU  - Ardizzoni A
AD  - Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy.
FAU - Massari, Francesco
AU  - Massari F
AUID- ORCID: 0000-0001-6476-6871
AD  - Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy. 
      fmassari79@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (Androstenes)
RN  - 15H5577CQD (Docetaxel)
RN  - G819A456D0 (abiraterone)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Androstenes/administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Disease Progression
MH  - Disease-Free Survival
MH  - Docetaxel/administration & dosage
MH  - Humans
MH  - Male
MH  - Neoplasm Grading
MH  - Prednisone/administration & dosage
MH  - Prostatic Neoplasms/*drug therapy
MH  - Randomized Controlled Trials as Topic
EDAT- 2020/01/30 06:00
MHDA- 2020/07/28 06:00
CRDT- 2020/01/30 06:00
PHST- 2020/01/30 06:00 [pubmed]
PHST- 2020/07/28 06:00 [medline]
PHST- 2020/01/30 06:00 [entrez]
AID - 10.1007/s40261-020-00888-5 [pii]
AID - 10.1007/s40261-020-00888-5 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2020 Mar;40(3):211-226. doi: 10.1007/s40261-020-00888-5.