Urologic Oncology Division, Department of Urology, ABC Medical School (FMABC), Santo André, Brazil.
Chemotherapy can reduce serum prostate-specific antigen (PSA) levels and relieve pain in some patients with castration-resistant prostate cancer (CRPC). To improve therapeutic efficacy numerous randomized trials have investigated docetaxel-based combination regimens. The present analysis tries to overcome the statistical limitations of the individual trials and investigates the treatment effects in total and in various combination groups.
The Medline, Embase, Cancerlit, and American Society of Clinical Oncology Abstract databases were searched for published randomized placebo-controlled trials evaluating the use of docetaxel-based regimens in patients with CRPC. The outcomes assessed were overall survival, overall response rate, PSA response rate, and adverse effects.
Twelve articles (2244 participants) were included in the meta-analysis. The analysis demonstrates a higher PSA response rate from docetaxel-based combinations when compared with docetaxel alone (relative risk [RR] = 1.16; P = .010). The estimated median survival in docetaxel-based combinations was statistically significantly longer than in the docetaxel-alone group (22.0 vs. 18.4 months; P = .037 ). Grade 3 or 4 neutropenia as well as grade 3 or 4 thromboembolic events were similar in both arms (overall RR, 0.87 [confidence interval (CI) 0.71-1.07]; P = .20 and overall RR 1.52 [0.79 - 2.90]; P = .21, respectively).
The analysis of 12 randomized trials provides evidence in favor of docetaxel-based combination chemotherapy for patients with CRPC and good performance status.
Written by:
Serpa Neto A, Tobias-Machado M, Kaliks R, Wroclawski ML, Pompeo AC, Del Giglio A. Are you the author?
Reference: Clin Genitourin Cancer. 2011 Sep 8. Epub ahead of print.
doi: 10.1016/j.clgc.2011.05.002
PubMed Abstract
PMID: 21907635
UroToday.com Prostate Cancer Section
