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Association between age and efficacy of combination systemic therapies in patients with metastatic hormone-sensitive prostate cancer: a systematic review and meta-analysis
P. Rajwa, T. Yanagisawa, I. Heidegger, F. Zattoni, G. Marra, TFW. Soeterik, RCN. van den Bergh, M. Valerio, F. Ceci, CV. Kesch, V. Kasivisvanathan, E. Laukhtina, T. Kawada, P. Nyiriadi, QD. Trinh, P. Chlosta, PI. Karakiewicz, G. Ploussard, A....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu metaanalýza, systematický přehled, časopisecké články, práce podpořená grantem
NLK
ProQuest Central
od 2000-07-01 do Před 1 rokem
Open Access Digital Library
od 1997-01-01
Health & Medicine (ProQuest)
od 2000-07-01 do Před 1 rokem
Public Health Database (ProQuest)
od 2000-07-01 do Před 1 rokem
- MeSH
- antagonisté androgenů terapeutické užití MeSH
- docetaxel MeSH
- hormony terapeutické užití MeSH
- lidé MeSH
- nádory prostaty * patologie MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
BACKGROUND: Combination systemic therapies have become the standard for metastatic hormone-sensitive prostate cancer (mHSPC). However, the effect of age on oncologic outcomes remains unknown. Our aim was to perform a systematic review, meta-analysis, and network meta-analysis (NMA) on the effect of chronological age on overall survival (OS) in patients treated with combination therapies for mHSPC. METHODS: We searched the PubMed®, Web of ScienceTM, and Scopus® databases to identify randomized controlled trials (RCTs) that analyzed the efficacy of combination systemic therapies using ADT plus docetaxel and/or androgen receptor signaling inhibitor (ARSI) in patients with mHSPC. We included studies, which provided separate hazard ratios (HRs) for younger vs. older patients. The selected age cut-off was 70 years (±5 years). Our outcome of interest was OS. RESULTS: We included nine RCTs with a total of 9183 patients. Younger and older men constituted 51% and 49% of included patients, respectively. Docetaxel plus ADT significantly improved OS among both older (HR 0.79, 95% CI 0.63-0.99, p = 0.04) and younger patients (HR 0.79, 95% CI 0.69-0.90, p < 0.001) with no differences according to age. ARSI plus ADT improved OS in older (HR 0.72, 95% CI 0.64-0.80, p < 0.001) and younger (HR 0.58, 95% CI 0.51-0.66, p < 0.001) patients; younger patients did benefit more (p = 0.02). On NMA treatment ranking, triplet therapy showed the highest probability of OS benefit irrespective of age group; in older patients, the benefit of triplet therapy compared to doublet was less expressed. CONCLUSIONS: Patients with mHSPC benefit from combination systemic therapies irrespective of age; the effect is, however, more evident in younger patients. Chronological age alone seems not to be a selection criteria for the administration of combination systemic therapies.
Department of Oncology and Hemato Oncology University of Milan Milan Italy
Department of Surgery Oncology and Gastroenterology University of Padua Padua Italy
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology CHUV Lausanne Lausanne Switzerland
Department of Urology Jagiellonian University Krakow Poland
Department of Urology La Croix du Sud Hospital Quint Fonsegrives France
Department of Urology Medical University Innsbruck Innsbruck Austria
Department of Urology Medical University of Silesia Zabrze Poland
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology San Giovanni Battista Hospital University of Torino Torino Italy
Department of Urology Semmelweis University Budapest Hungary
Department of Urology St Antonius Hospital Utrecht The Netherlands
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University of Texas Southwestern Dallas TX USA
Department of Urology Weill Cornell Medical College New York NY USA
Division of Nuclear Medicine European Institute of Oncology IRCCS Milan Italy
Division of Surgery and Interventional Science University College London London UK
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordan
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Unit of Urology Division of Oncology IRCCS San Raffaele San Raffaele Hospital Milan Italy
Citace poskytuje Crossref.org
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