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Current Oncology
Volume 26
Issue 1
10.3747/co.26.4203
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Article

Efficacy and Safety of Combined Androgen Blockade with Antiandrogen for Advanced Prostate Cancer

by
Y. Yang
,
R. Chen
,
T. Sun
,
L. Zhao
,
F. Liu
,
S. Ren
,
H. Wang
,
X. Lu
,
X. Gao
,
C. Xu
and
Yinghao Sun
*
Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2019, 26(1), 4203; https://doi.org/10.3747/co.26.4203
Submission received: 7 November 2018 / Revised: 13 December 2018 / Accepted: 13 January 2019 / Published: 1 February 2019

Abstract

Background: Combined androgen blockade (CAB) is a promising treatment modality for prostate cancer (PCA). In the present meta-analysis, we compared the efficacy and safety of first-line CAB using an antiandrogen (AA) with castration monotherapy in patients with advanced PCA. Methods: PubMed, embase, Cochrane, and Google Scholar were searched for randomized controlled trials (RCTS) published through 12 December 2016. Hazard ratios (HRS) with 95% confidence intervals (CIS) were determined for primary outcomes: overall survival (OS) and progression-free survival (PFS). Subgroup analyses were performed for Western compared with Eastern patients and use of a nonsteroidal AA (NSAA) compared with a steroidal AA (SAA). Results: Compared with castration monotherapy, CAB using an AA was associated with significantly improved OS (n = 14; HR: 0.90; 95% CI: 0.84 to 0.97; p = 0.003) and PFS (n = 13; HR: 0.89; 95% CI: 0.80 to 1.00; p = 0.04). No significant difference in OS (p = 0.71) and PFS (p = 0.49) was observed between the Western and Eastern patients. Compared with castration monotherapy, CAB using a NSAA was associated with significantly improved OS (HR: 0.88; 95% CI: 0.82 to 0.95; p = 0.0009) and PFS (HR: 0.85; 95% CI: 0.73 to 0.98; p = 0.007)—a result that was not achieved with CAB using a SAA. The safety profiles of CAB and monotherapy were similar in terms of adverse events, including hot flushes, impotence, and grade 3 or 4 events, with the exception of risk of diarrhea and liver dysfunction or elevation in liver enzymes, which were statistically greater with CAB using an AA. Conclusions: Compared with castration monotherapy, first-line CAB therapy with an AA, especially a NSAA, resulted in significantly improved OS and PFS, and had an acceptable safety profile in patients with advanced PCA.
Keywords: prostate cancer, advanced; antiandrogens; androgen blockade, combined; castration monotherapy; overall survival; progression-free survival; safety prostate cancer, advanced; antiandrogens; androgen blockade, combined; castration monotherapy; overall survival; progression-free survival; safety

Share and Cite

MDPI and ACS Style

Yang, Y.; Chen, R.; Sun, T.; Zhao, L.; Liu, F.; Ren, S.; Wang, H.; Lu, X.; Gao, X.; Xu, C.; et al. Efficacy and Safety of Combined Androgen Blockade with Antiandrogen for Advanced Prostate Cancer. Curr. Oncol. 2019, 26, 4203. https://doi.org/10.3747/co.26.4203

AMA Style

Yang Y, Chen R, Sun T, Zhao L, Liu F, Ren S, Wang H, Lu X, Gao X, Xu C, et al. Efficacy and Safety of Combined Androgen Blockade with Antiandrogen for Advanced Prostate Cancer. Current Oncology. 2019; 26(1):4203. https://doi.org/10.3747/co.26.4203

Chicago/Turabian Style

Yang, Y., R. Chen, T. Sun, L. Zhao, F. Liu, S. Ren, H. Wang, X. Lu, X. Gao, C. Xu, and et al. 2019. "Efficacy and Safety of Combined Androgen Blockade with Antiandrogen for Advanced Prostate Cancer" Current Oncology 26, no. 1: 4203. https://doi.org/10.3747/co.26.4203

APA Style

Yang, Y., Chen, R., Sun, T., Zhao, L., Liu, F., Ren, S., Wang, H., Lu, X., Gao, X., Xu, C., & Sun, Y. (2019). Efficacy and Safety of Combined Androgen Blockade with Antiandrogen for Advanced Prostate Cancer. Current Oncology, 26(1), 4203. https://doi.org/10.3747/co.26.4203

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