PMID- 34548234
OWN - NLM
STAT- MEDLINE
DCOM- 20220217
LR  - 20220217
IS  - 1873-2496 (Electronic)
IS  - 1078-1439 (Linking)
VI  - 40
IP  - 1
DP  - 2022 Jan
TI  - Efficacy and safety of bipolar androgen therapy in mCRPC after progression on 
      abiraterone or enzalutamide: A systematic review.
PG  - 4.e19-4.e28
LID - S1078-1439(21)00377-X [pii]
LID - 10.1016/j.urolonc.2021.08.014 [doi]
AB  - PURPOSE: To further determine the efficacy and safety of bipolar androgen therapy 
      (BAT) on patients with metastatic castration-resistant prostate cancer (mCRPC) 
      after progression on abiraterone (ABI) or enzalutamide (ENZA). MATERIALS AND 
      METHODS: We systematically searched the Pubmed, Web of Science and 
      ClinicalTrials.gov up to June 2021. Literature review, study selection, and data 
      extraction were conducted by 2 reviewers. Risk of bias was assessed according to 
      the methodology of the European Association of Urology (EAU). A systematic review 
      and pooled analysis were performed. The primary outcomes were PSA50 after BAT and 
      AR-targeted therapy rechallenge, objective response rate (ORR) after BAT, and AEs 
      after BAT. The definition of PSA50 was that participants achieving a PSA decline 
      >/=50% according to Prostate Cancer Working Group (PCWG2) criteria. The ORR 
      determined by determined by Response Evaluation Criteria in Solid Tumors (RECIST) 
      included patients experienced partial response (PR) or complete response (CR). 
      RESULTS: In a total of 74 unique records, 5 studies were eligible for inclusion. 
      Participants who underwent BAT achieved PSA50 of 0.26 (95% CI [0.20, 0.32]) and 
      objective response rate (ORR) of 0.32 (95% CI [0.21, 0.44]). Patients completed 
      BAT proceeded to AR-target therapy (ABI or ENZA) achieved moderate response 
      (PSA50 0.54, 95% CI [0.30, 0.76]). Based on our multiple subgroup analysis, type 
      of post-BAT AR-target therapy had a strong impact on PSA50 of AR-target therapy 
      rechallenge. Most of adverse events (AEs) were low grade. CONCLUSIONS: The 
      present study indicated that BAT could induce clinical responses in mCRPC 
      patients after progression on ABI or ENZA, with an acceptable side effects 
      profile. BAT could also be able to restore sensitivity to ABI and ENZA 
      rechallenge in a subset of patients.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Xiong, Xingyu
AU  - Xiong X
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Qiu, Shi
AU  - Qiu S
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China; Center of Biomedical big data, West 
      China Hospital, Sichuan University, Chengdu, China.
FAU - Yi, Xianyanling
AU  - Yi X
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Xu, Hang
AU  - Xu H
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Lei, Haoran
AU  - Lei H
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Liao, Dazhou
AU  - Liao D
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Bai, Shengjiang
AU  - Bai S
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Peng, Ge
AU  - Peng G
AD  - Department of Endocrinology and Metabolism, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Wei, Qiang
AU  - Wei Q
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China.
FAU - Ai, Jianzhong
AU  - Ai J
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China. Electronic address: 
      ajz6363@126.com.
FAU - Yang, Lu
AU  - Yang L
AD  - Department of Urology, Institute of Urology, Center of Biomedical big data and 
      National Clinical Research Center for Geriatrics, West China Hospital of Sichuan 
      University, Chengdu, Sichuan Province, China. Electronic address: 
      wycleflue@163.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20210920
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
RN  - 0 (Androgens)
RN  - 0 (Androstenes)
RN  - 0 (Benzamides)
RN  - 0 (Nitriles)
RN  - 2010-15-3 (Phenylthiohydantoin)
RN  - 3XMK78S47O (Testosterone)
RN  - 93T0T9GKNU (enzalutamide)
RN  - G819A456D0 (abiraterone)
SB  - IM
MH  - Androgens/*administration & dosage/adverse effects
MH  - Androstenes/therapeutic use
MH  - Benzamides/therapeutic use
MH  - Disease Progression
MH  - Humans
MH  - Male
MH  - Neoplasm Metastasis
MH  - Nitriles/therapeutic use
MH  - Phenylthiohydantoin/therapeutic use
MH  - Prostatic Neoplasms, Castration-Resistant/*drug therapy/pathology
MH  - Testosterone/*administration & dosage/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Abiraterone
OT  - Bipolar androgen therapy
OT  - Enzalutamide
OT  - Metastatic castration-resistant prostate cancer
OT  - Systematic review
COIS- Conflict of interest We declare that we do not have any commercial or associative 
      interest that represents a conflict of interest in connection with the work 
      submitted.
EDAT- 2021/09/23 06:00
MHDA- 2022/02/19 06:00
CRDT- 2021/09/22 05:51
PHST- 2021/01/10 00:00 [received]
PHST- 2021/07/04 00:00 [revised]
PHST- 2021/08/13 00:00 [accepted]
PHST- 2021/09/23 06:00 [pubmed]
PHST- 2022/02/19 06:00 [medline]
PHST- 2021/09/22 05:51 [entrez]
AID - S1078-1439(21)00377-X [pii]
AID - 10.1016/j.urolonc.2021.08.014 [doi]
PST - ppublish
SO  - Urol Oncol. 2022 Jan;40(1):4.e19-4.e28. doi: 10.1016/j.urolonc.2021.08.014. Epub 
      2021 Sep 20.