Giandomenico Roviello1, Silvia Paola Corona2, Michele Aieta3, Raheleh Roudi4. 1. 1 Division of Medical Oncology, Department of Onco-Hematology, IRCCS-CROB, Referral Cancer Center of Basilicata, Vulture, Italy. 2. 2 Radiation Oncology Department, Peter MacCallum Cancer Centre, East Bentleigh, Victoria, Australia. 3. 3 Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy. 4. 4 Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Abstract
BACKGROUND: Novel hormonal therapies (NHTs) have enriched the therapeutic armamentarium available for patients with castration-resistant prostate cancer. However, there is a need for clinical indicators able to drive treatment decisions and timing. The aim of this report is to perform a pooled analysis based on all available literature focused on prediction of efficacy and survival in patients treated with NHTs before and postchemotherapy. METHODS: After reviewing the studies included in this work, the efficacy and the survival of NHTs according to age and Gleason score (GS) was focused. RESULTS: A total of eight studies were included in the analysis. With regard to age, the survival hazard ratio shows a better outcome, for both elderly and young patients, in postchemotherapy studies. With regard to progression-free survival, the subgroup analysis of pre- and postchemotherapy studies demonstrates the effect of NHTs on the reduction of risk of progression is greater in prechemotherapy studies irrespective of age. With regard to GS, NHTs show higher efficacy when administered postchemotherapy in patients with GS <8, whereas in patients with GS ≥8 NHTs are more effective in the prechemotherapy setting. CONCLUSION: Given the limitations of a meta-analysis of data from the literature, the results show that progression-free survival is always higher when NHTs are administered prechemotherapy in comparison with postchemotherapy. This benefit, however, translates in a reduction of risk of death only in patients with GS ≥8. In the other patients, the risk of death decreases when NHTs are administered postchemotherapy.
BACKGROUND: Novel hormonal therapies (NHTs) have enriched the therapeutic armamentarium available for patients with castration-resistant prostate cancer. However, there is a need for clinical indicators able to drive treatment decisions and timing. The aim of this report is to perform a pooled analysis based on all available literature focused on prediction of efficacy and survival in patients treated with NHTs before and postchemotherapy. METHODS: After reviewing the studies included in this work, the efficacy and the survival of NHTs according to age and Gleason score (GS) was focused. RESULTS: A total of eight studies were included in the analysis. With regard to age, the survival hazard ratio shows a better outcome, for both elderly and young patients, in postchemotherapy studies. With regard to progression-free survival, the subgroup analysis of pre- and postchemotherapy studies demonstrates the effect of NHTs on the reduction of risk of progression is greater in prechemotherapy studies irrespective of age. With regard to GS, NHTs show higher efficacy when administered postchemotherapy in patients with GS <8, whereas in patients with GS ≥8 NHTs are more effective in the prechemotherapy setting. CONCLUSION: Given the limitations of a meta-analysis of data from the literature, the results show that progression-free survival is always higher when NHTs are administered prechemotherapy in comparison with postchemotherapy. This benefit, however, translates in a reduction of risk of death only in patients with GS ≥8. In the other patients, the risk of death decreases when NHTs are administered postchemotherapy.
Authors: Lourdes R Carhuapoma; Winter M Thayer; Catherine E Elmore; Jane Gildersleeve; Tanmay Singh; Farah Shaukat; Melissa K Uveges; Tamryn Gray; Crystal Chu; Daniel Song; Patricia J Hollen; Jennifer Wenzel; Randy A Jones Journal: Trials Date: 2021-09-16 Impact factor: 2.728