Is There a Benefit of Addition Docetaxel, Abiraterone, Celecoxib, or Zoledronic Acid in Initial Treatments for Patients Older Than 70 Years With Hormone-sensitive Advanced Prostate Cancer? A Meta-analysis

Landre, Thierry; Guetz, G. Des; Chouahnia, Kader; Fossey-Diaz, Virginie; Taleb, Chérifa; Culine, Stéphane

doi:10.1016/j.clgc.2019.05.001

Cited by 7 publications

(30 citation statements)

References 28 publications

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“…As chemotherapies and potent androgen receptor‐axis‐targeted agents carry the risk of serious adverse effects, such as bone marrow suppression, interstitial pneumonia, cardiovascular disorder, and liver function disorder, and also may involve significant financial burdens, appropriate indications for the use of these agents should be carefully discussed. In addition, a meta‐analysis revealed that the administration of docetaxel and abiraterone acetate combination with ADT did not improve OS compared with ADT alone in patients >70 years old 16 . Patients with de novo metastatic PCa tend to be relatively old at diagnosis (median age was 73 years in our study and 70 years in a Japanese prospective cohort study) 12 .…”

Section: Discussionmentioning

confidence: 58%

“…In addition, a meta-analysis revealed that the administration of docetaxel and abiraterone acetate combination with ADT did not improve OS compared with ADT alone in patients >70 years old. 16 Patients with de novo metastatic PCa tend to be relatively old at diagnosis (median age was 73 years in our study and 70 years in a Japanese prospective cohort study). 12 Considering these issues, selection should be more discussed to those patients requiring potent upfront treatment in mCNPC.…”

Section: Discussionmentioning

confidence: 64%

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How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

et al. 2020

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Background Recent landmark randomized trials (CHAARTED and LATITUDE studies) have highlighted potent upfront therapy for “high‐volume” and “high‐risk” metastatic castration‐naïve prostate cancer (mCNPC). However, treatment response shows racial differences. We aimed to propose a novel definition for “high‐volume” prostate cancer in Asians. Methods We retrospectively pursued 426 patients with de novo mCNPC from multiple institutions between 1999 and 2017. All patients received androgen deprivation therapy alone as initial treatment. We evaluated the number of bone metastases at diagnosis to clarify the clinical significance for progression‐free survival and overall survival (OS). Statistical analyses were conducted using the Mann‐Whitney U test, Cox proportional hazard models, and Kaplan‐Meier methods. Results Median age and prostate‐specific antigen level were 73 years and 266.2 ng/ml, respectively. Median OS was 55.5 months in patients who met the CHAARTED high criteria (vs 33.1 months in the trial). We evaluated 5 thresholds in the number of bone metastases (≥4, ≥6, ≥11, ≥16, and ≥21) to investigate the prognostic values. Patients with ≥11 bone metastases showed the highest HR for OS (2.766). Patients with 11 to 20 bone metastases had a significantly shorter OS than those with ≤10 metastases (P = .0001). We, therefore, proposed modified CHAARTED and LATITUDE high criteria (extending bone metastases ≥11). In multivariate analysis, the modified criteria were the only independent prognostic factors for OS (P = .0272 and P = .042, respectively). Conversely, no significant differences in OS were seen between patients with 1 to 3 bone metastases and 4 to 10 (P = .7513). Conclusion Our exploratory study suggested ≥11 bone metastases as a suitable definition for “high‐volume” prostate cancer in Asians. A larger, prospective study is warranted to verify our findings.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 64%

How many bone metastases may be defined as high‐volume metastatic prostate cancer in Asians: A retrospective multicenter cohort study

et al. 2020

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“…Of these 5 SRs, 3 were published in 2020, 13,16,17 1 in 2019, 14 and 1 in 2018. 15 The literature searches ranged from database inception to May 15, 2020.…”

Section: Methodsmentioning

confidence: 99%

“…Three [13][14][15] of the 5 SRs had broader inclusion criteria than the present review. Specifically, these 3 SRs included studies with both mCSPC and either non-mCSPC 14,15 or mCRPC.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

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Abiraterone Acetate for Metastatic Castration-Sensitive Prostate Cancer

Shane¹,

Walter²

2021

cjht

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The use of abiraterone acetate for the treatment of metastatic castration-sensitive prostate cancer is clinically effective. Compared with standard of care, abiraterone acetate was associated with increased overall survival, increased prostate cancer–specific survival, increased progression-free survival, and improved quality of life. Patients treated with abiraterone acetate were at higher risk for grade III to grade V adverse events (severe, life-threatening, or fatal) and were more likely to discontinue treatment compared with standard of care. The incremental cost-effectiveness ratios for both brand and generic abiraterone acetate were estimated to be higher than common willingness-to-pay thresholds.

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