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Poster display session

4850 - Efficacy and safety of first-line combined androgen blockade in advanced prostate cancer: A meta-analysis

Date

10 Sep 2017

Session

Poster display session

Presenters

Yinghao Sun

Citation

Annals of Oncology (2017) 28 (suppl_5): v269-v294. 10.1093/annonc/mdx370

Authors

Y. Sun, Y. Yang, R. Chen, L. Zhao, F. Liu, S. Ren, H. Wang, X. Lu, X. Gao, C. Xu

Author affiliations

  • Department Of Urology, Shanghai Changhai Hospital, 200433 - Shanghai/CN
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Resources

Abstract 4850

Background

Combined androgen blockade (CAB) is one of the therapies for advanced prostate cancer. In this analysis, we compared the efficacy and safety of first-line CAB with castration monotherapy in advanced prostate cancer patients.

Methods

The meta-analysis was PRISMA compliant and was registered in PROSPERO (CRD42016054301). We searched PubMed, EMBASE, Cochrane and Scholar for randomized controlled trials (RCTs) published through 12th December 2016 and compared efficacy and safety of first line CAB vs. luteinizing hormone releasing hormone agonists (LHRHa) monotherapy/orchiectomy in advanced prostate cancer. Overall survival (OS) and progression free survival (PFS) were the primary outcomes (fixed/random effects model). Safety was the secondary outcome. Sub-group analyses included: i) Eastern vs. Western patients; ii) non-steroidal anti-androgen (NSAA) vs. steroidal anti-androgen (SAA). Studies with reported HR/presenting median survival and JADAD score >2 were included.

Results

We identified 16 studies (6084 patients; West-12; East-4) for inclusion. CAB treatment significantly improved the OS (14 RCTS; HR 0.90; 95% CI 0.84 to 0.97, P = 0.003) and PFS (13 RCTs; HR 0.89; 95% CI 0.80 to 1.00, P = 0.04) in advanced prostate cancer patients, compared with monotherapy. No significant difference in OS (P = 0.71) and PFS (P = 0.49) was observed between Western vs. Eastern patients. CAB with NSAA 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); whereas, CAB with SAA reported similar OS (HR 1.03; 95% CI 0.86 to 1.25, P = 0.74) or PFS (HR 1.01; 95% CI 0.87 to 1.17, P = 0.74) compared with castration monotherapy. Incidence of grade 3 or 4 AEs was not significantly different between CAB and castration monotherapy (P = 0.1083).

Conclusions

First-line CAB therapy significantly improved OS and PFS in advanced prostate cancer patients, with no significant difference in grade 3 or 4 AEs compared with castration monotherapy.

Clinical trial identification

Legal entity responsible for the study

Shanghai Changhai Hospital. 168 Changhai Road, Shanghai 200433, China

Funding

AstraZeneca

Disclosure

All authors have declared no conflicts of interest.

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