Quality of Life Effects of Intermittent and Continuous Hormonal Therapy by Cyproterone Acetate (Cpa) for Metastatic Prostate Cancer

Verhagen, Paul C.M.S.; Wissenburg, L.D.; Wildhagen, Mark F.; Bolle, W.A.B.M.; Verkerk, A.M.; Schröder, F.H.; Bangma, Chris H.; Mickisch, G.

doi:10.1016/s1569-9056(08)60537-0

Cited by 18 publications

(27 citation statements)

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“…QoL was assessed as an end‐point parameter in 64% (9/13) of the studies evaluated. Of the nine studies that evaluated QoL, four showed a QoL benefit in patients treated with IAD, 28,38,42,43 whereas the remaining five did not show any significant difference between IAD and CAD 31,35,36,39,41 …”

Section: Resultsmentioning

confidence: 99%

Safety and tolerability of intermittent androgen deprivation therapy: A literature review

2012

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Androgen deprivation therapy is commonly used in men with advanced prostate cancer; however, it is associated with many short‐ and long‐term side‐effects. Intermittent androgen deprivation therapy was first suggested as an alternative regimen in the early 1990s and is now part of treatment guidelines as a result of its ability to reduce adverse events associated with continuous androgen deprivation therapy without decreasing its efficacy. Although many publications evaluated intermittent androgen deprivation therapy's efficacy, the safety and tolerability information of this regimen is relatively limited. The goal of this literature review was to analyze clinical trials that have reported safety and tolerability data in prostate cancer patients treated with intermittent androgen deprivation therapy, as well as assessing quality of life outcomes. A literature search was carried out using biomedical and pharmaceutical databases for published information comparing intermittent androgen deprivation therapy with continuous androgen deprivation therapy. A total of 13 randomized and non‐randomized studies were selected and reviewed based on their relevance to the safety, tolerability and quality of life of intermittent androgen deprivation therapy. Benefits for intermittent androgen deprivation therapy were observed for the short‐term side‐effects (hot flushes and sexual functions) mainly during the off‐treatment phase, whereas the data for the long‐term side‐effects were not as conclusive. Quality of life evaluations are more in support of intermittent androgen deprivation therapy. Although there are some safety, tolerability and quality of life benefits associated with intermittent androgen deprivation therapy, the overall evidence is still limited.

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Section: Resultsmentioning

confidence: 99%

Safety and tolerability of intermittent androgen deprivation therapy: A literature review

2012

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“…The search process is described in Figure 1. We excluded trials that did not assess mortality outcomes 18,19 or provide count data on outcomes of interest after attempted contacts. 20,21 We included 4664 men with advanced PCa from 8 trials in this meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Most clinical trials used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 instrument to assess QoL associated with IADT compared with CADT, but few studies reported the raw scores in IADT and CADT groups. Several studies concluded that IADT had a better QoL outcome in hot flashes and sexual function, 9–11,19,20 although some studies found no clinically significant difference. 12,16 …”

Section: Resultsmentioning

confidence: 99%

Efficacy of Intermittent Androgen Deprivation Therapy vs Conventional Continuous Androgen Deprivation Therapy for Advanced Prostate Cancer: A Meta-analysis

Tsai

Penson

Makambi

et al. 2013

Urology

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OBJECTIVE To compare the efficacy of intermittent androgen deprivation therapy (IADT) vs continuous androgen deprivation therapy (CADT) for the treatment of advanced prostate cancer; we performed a meta-analysis of randomized controlled trials (RCTs), assessing the risks of disease progression, all-cause, and disease-specific mortality. MATERIALS AND METHODS We conducted a systematic search of several bibliographic systems to identify all RCTs of IADT in men with newly diagnosed metastatic or biochemical only prostate cancer. We abstracted outcome data, study characteristics, and participant demographics. We performed heterogeneity tests and calculated the summarized risk differences (RD) and risk ratios at 95% confidence intervals (CI), using inverse variance methods in random-effects approaches. RESULTS We identified 8 RCTs (N = 4664) comparing mortality between IADT and CADT. For all men combined, we observed small but nonsignificant differences in all-cause mortality (RD = 0.02, 95% CI = −0.02, 0.06), disease-specific mortality (RD = 0.04, 95% CI = −0.01, 0.08), and disease progression (RD = −0.03, 95% CI = −0.09, 0.04). Among the prespecified subgroup with histologically confirmed, newly diagnosed metastatic disease, we found no difference in overall survival (RD = 0.00, 95% CI = −0.09, 0.09). CONCLUSION We found no difference in overall survival, but a small increased risk in disease-specific survival for men treated with IADT relative to CADT was observed. IADT could be considered as an alternative to CADT because of better quality of life outcome. Patients should be informed of the possible risks and benefits of both therapies. More research confirming the benefits of IADT vs CADT is needed to inform treatment decisions.

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“…This was supported in two studies (Cherrier et al 2003;Almeida et al 2004), however, men receiving Intermittent ADT reported poorer scores on a self-reported cognitive function measure compared to men receiving continuous ADT (Verhagen et al 2008). …”

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confidence: 76%

Cognitive impairment among prostate cancer patients: An overview of reviews

Treanor

Donnelly

2017

Eur J Cancer Care

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To identify and clarify definitions and methods of measuring cancer‐related cognitive impairment among prostate cancer patients treated with androgen deprivation therapy (ADT) and to assess the incidence and prevalence of cognitive impairment. A systematic review of Medline, EMBASE, PubMed, PsycINFO and CINAHL up to December 2015 was undertaken to identify English‐language reviews. A total of 28 reviews were identified describing 20 primary studies. There were no studies of incidence. Reported prevalence rates varied between 10% and 69%. Cognitive domains impaired by ADT included: verbal memory, visuospatial ability and executive functions. Cognitive impairment was infrequently defined and four definitions were reported. A variety of measures and methods were used to assess cognitive function including neuropsychological tests, self‐report measures and clinical assessments. The finding that, often, one measure was used to assess more than one aspect of cognition is likely to have contributed to imprecise estimates. There is a need to agree a definition of cognitive impairment in the clinical epidemiology of cancer and to standardise the selection of measures in order to aid accurate assessment and fair comparisons across studies regarding the prevalence of cognitive impairment among prostate cancer patients.

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Quality of Life Effects of Intermittent and Continuous Hormonal Therapy by Cyproterone Acetate (Cpa) for Metastatic Prostate Cancer

Cited by 18 publications

References 0 publications

Safety and tolerability of intermittent androgen deprivation therapy: A literature review

Safety and tolerability of intermittent androgen deprivation therapy: A literature review

Efficacy of Intermittent Androgen Deprivation Therapy vs Conventional Continuous Androgen Deprivation Therapy for Advanced Prostate Cancer: A Meta-analysis

Cognitive impairment among prostate cancer patients: An overview of reviews

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