PMID- 36695246
OWN - NLM
STAT- MEDLINE
DCOM- 20230721
LR  - 20230811
IS  - 1745-7262 (Electronic)
IS  - 1008-682X (Print)
IS  - 1008-682X (Linking)
VI  - 25
IP  - 4
DP  - 2023
TI  - The safety of radium-223 combined with new-generation hormonal agents in bone 
      metastatic castration-resistant prostate cancer: a systematic review and network 
      meta-analysis.
PG  - 441-447
LID - 10.4103/aja2022108 [doi]
AB  - Patients with bone metastatic castration-resistant prostate cancer (mCRPC) might 
      benefit from radium-223 ((223)Ra) combined with new-generation hormonal agents 
      (NHAs) in terms of survival and quality of life (QoL). However, the safety of 
      combination therapies remains unclear. Therefore, we aimed to perform a network 
      meta-analysis by reviewing the literature about the combination of (223)Ra with 
      abiraterone acetate plus prednisone (AAP) or enzalutamide and to evaluate the 
      safety of combination therapy in bone mCRPC patients. Ultimately, ten studies 
      (2835 patients) were selected, including four randomized controlled trials 
      (RCTs), five retrospective cohort studies, and one single-arm study. Overall, 
      there was no difference in the incidence of fracture between the (223)Ra+NHA 
      combination group and the (223)Ra monotherapy group (odds ratio [OR]: 1.46, 95% 
      confidence interval [CI]: 0.91-2.34, P = 0.66), but the incidences in both the 
      (223)Ra+NHA combination group (OR: 3.22, 95% CI: 2.24-4.63, P < 0.01) and the 
      (223)Ra monotherapy group (OR: 2.24, 95% CI: 1.23-4.08, P < 0.01) were higher 
      than that in the NHA monotherapy group. However, in the meta-analysis involving 
      only RCTs, there was no difference between the (223)Ra monotherapy group and the 
      NHA monotherapy group (OR: 1.14, 95% CI: 0.22-5.95, P = 0.88), while the 
      difference between the (223)Ra+NHA combination group and the NHA monotherapy 
      group remained significant (OR: 3.22, 95% CI: 2.24-4.63, P < 0.01). Symptomatic 
      skeletal events (SSEs), SSE-free survival (SSE-FS), all grades of common adverse 
      events (AEs), and >/=grade 3 AEs among all groups did not show any significant 
      difference. Our results indicate that the combination of (223)Ra with NHAs was 
      well tolerated in bone mCRPC patients compared to (223)Ra monotherapy, even 
      though the incidence of fracture was higher in patients who received (223)Ra than 
      that among those who received NHA monotherapy. More evidence is needed to explore 
      the safety and efficiency of (223)Ra combination therapies.
FAU - Wang, Ming-Hao
AU  - Wang MH
AD  - Department of Urology, West China Hospital of Sichuan University, Chengdu 610041, 
      China.
FAU - Dai, Jin-Dong
AU  - Dai JD
FAU - Zhang, Xing-Ming
AU  - Zhang XM
FAU - Zhao, Jin-Ge
AU  - Zhao JG
FAU - Sun, Guang-Xi
AU  - Sun GX
FAU - Zeng, Yu-Hao
AU  - Zeng YH
FAU - Zeng, Hong
AU  - Zeng H
FAU - Xu, Nan-Wei
AU  - Xu NW
FAU - Zeng, Hao
AU  - Zeng H
FAU - Shen, Peng-Fei
AU  - Shen PF
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - China
TA  - Asian J Androl
JT  - Asian journal of andrology
JID - 100942132
RN  - 8BR2SOL3L1 (Radium-223)
RN  - EM5OCB9YJ6 (Abiraterone Acetate)
RN  - VB0R961HZT (Prednisone)
RN  - W90AYD6R3Q (Radium)
SB  - IM
MH  - Male
MH  - Humans
MH  - *Prostatic Neoplasms, Castration-Resistant/drug therapy/radiotherapy
MH  - Network Meta-Analysis
MH  - Abiraterone Acetate/therapeutic use
MH  - Prednisone/therapeutic use
MH  - *Radium/adverse effects
MH  - *Fractures, Bone
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
PMC - PMC10411251
OTO - NOTNLM
OT  - meta-analysis
OT  - metastatic castration-resistant prostate cancer
OT  - new-generation hormonal agents
OT  - radium-223
OT  - safety
COIS- None
EDAT- 2023/01/26 06:00
MHDA- 2023/07/21 06:43
PMCR- 2023/01/20
CRDT- 2023/01/25 05:30
PHST- 2023/07/21 06:43 [medline]
PHST- 2023/01/26 06:00 [pubmed]
PHST- 2023/01/25 05:30 [entrez]
PHST- 2023/01/20 00:00 [pmc-release]
AID - 00129336-990000000-00068 [pii]
AID - AJA-25-441 [pii]
AID - 10.4103/aja2022108 [doi]
PST - ppublish
SO  - Asian J Androl. 2023;25(4):441-447. doi: 10.4103/aja2022108.