Association between age and efficacy of combination systemic therapies in patients with metastatic hormone-sensitive prostate cancer: a systematic review and meta-analysis

被引：6

作者：

Rajwa, Pawel ^{[1
,2
]}

Yanagisawa, Takafumi ^{[1
,3
]}

Heidegger, Isabel ^{[4
]}

Zattoni, Fabio ^{[5
]}

Marra, Giancarlo ^{[6
]}

Soeterik, Timo F. W. ^{[7
]}

van den Bergh, Roderick C. N. ^{[7
]}

Valerio, Massimo ^{[8
]}

Ceci, Francesco ^{[9
,10
]}

Kesch, Claudia, V ^{[11
]}

Kasivisvanathan, Veeru ^{[12
]}

Laukhtina, Ekaterina ^{[1
,13
]}

Kawada, Tatsushi ^{[1
,14
]}

Nyiriadi, Peter ^{[15
]}

Quoc-Dien Trinh ^{[16
,17
]}

Chlosta, Piotr ^{[18
]}

Karakiewicz, Pierre, I ^{[19
]}

Ploussard, Guillaume ^{[20
]}

Briganti, Alberto ^{[21
]}

Montorsi, Francesco ^{[21
]}

Shariat, Shahrokh F. ^{[1
,13
,22
,23
,24
,25
]}

Gandaglia, Giorgio ^{[21
]}

机构：

[1] Med Univ Vienna, Dept Urol, Vienna, Austria

[2] Med Univ Silesia, Dept Urol, Zabrze, Poland

[3] Jikei Univ, Dept Urol, Sch Med, Tokyo, Japan

[4] Med Univ Innsbruck, Dept Urol, Innsbruck, Austria

[5] Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy

[6] Univ Torino, San Giovanni Battista Hosp, Dept Urol, Turin, Italy

[7] St Antonius Hosp, Dept Urol, Utrecht, Netherlands

[8] CHUV Lausanne, Dept Urol, Lausanne, Switzerland

[9] European Inst Oncol IRCCS, Div Nucl Med, Milan, Italy

[10] Univ Milan, Dept Oncol & Hematooncol, Milan, Italy

[11] Univ Hosp Essen, Essen German Canc Consortium DKTK Univ Hosp Essen, Dept Urol, Essen, Germany

[12] UCL, Div Surg & Intervent Sci, London, England

[13] Sechenov Univ, Inst Urol & Reprod Hlth, Moscow, Russia

[14] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol, Okayama, Japan

[15] Semmelweis Univ, Dept Urol, Budapest, Hungary

[16] Harvard Med Sch, Div Urol Surg, Brigham & Womens Hosp, Boston, MA 02115 USA

[17] Harvard Med Sch, Ctr Surg & Publ Hlth, Brigham & Womens Hosp, Boston, MA 02115 USA

[18] Jagiellonian Univ, Dept Urol, Krakow, Poland

[19] Univ Montreal, Hlth Ctr, Div Urol, Canc Prognost & Hlth Outcomes Unit, Montreal, PQ, Canada

[20] La Croix du Sud Hosp, Dept Urol, Quint Fonsegrives, France

[21] Osped San Raffaele, Div Oncol, Unit Urol, IRCCS San Raffaele, Milan, Italy

[22] Charles Univ Prague, Fac Med 2, Dept Urol, Prague, Czech Republic

[23] Al Ahliyya Amman Univ, Hourani Ctr Appl Sci Res, Amman, Jordan

[24] Weill Cornell Med Coll, Dept Urol, New York, NY 10021 USA

[25] Univ Texas Southwestern, Dept Urol, Dallas, TX 75390 USA

来源：

PROSTATE CANCER AND PROSTATIC DISEASES | 2023年 / 26卷 / 01期

关键词：

RADICAL PROSTATECTOMY; LIFE-EXPECTANCY; OLDER; ENZALUTAMIDE; SURVIVAL; SAFETY; RADIOTHERAPY; MANAGEMENT; INHIBITORS; RISK;

D O I：

10.1038/s41391-022-00607-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BACKGROUND: Combination systemic therapies have become the standard for metastatic hormone-sensitive prostate cancer (mHSPC). However, the effect of age on oncologic outcomes remains unknown. Our aim was to perform a systematic review, metaanalysis, and network meta-analysis (NMA) on the effect of chronological age on overall survival (OS) in patients treated with combination therapies for mHSPC. METHODS: We searched the PubMed (R), Web of Science (TM), and Scopus (R) databases to identify randomized controlled trials (RCTs) that analyzed the efficacy of combination systemic therapies using ADT plus docetaxel and/or androgen receptor signaling inhibitor (ARSI) in patients with mHSPC. We included studies, which provided separate hazard ratios (HRs) for younger vs. older patients. The selected age cut-off was 70 years (+/- 5 years). Our outcome of interest was OS. RESULTS: We included nine RCTs with a total of 9183 patients. Younger and older men constituted 51% and 49% of included patients, respectively. Docetaxel plus ADT significantly improved OS among both older (HR 0.79, 95% CI 0.63-0.99, p = 0.04) and younger patients (HR 0.79, 95% CI 0.69-0.90, p < 0.001) with no differences according to age. ARSI plus ADT improved OS in older (HR 0.72, 95% CI 0.64-0.80, p < 0.001) and younger (HR 0.58, 95% CI 0.51-0.66, p < 0.001) patients; younger patients did benefit more (p = 0.02). On NMA treatment ranking, triplet therapy showed the highest probability of OS benefit irrespective of age group; in older patients, the benefit of triplet therapy compared to doublet was less expressed. CONCLUSIONS: Patients with mHSPC benefit from combination systemic therapies irrespective of age; the effect is, however, more evident in younger patients. Chronological age alone seems not to be a selection criteria for the administration of combination systemic therapies.

引用

页码：170 / 179

页数：10

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