Combined Chemohormonal Strategy in Hormone-Sensitive Prostate Cancer: A Pooled Analysis of Randomized Studies

The value of chemohormonal strategies in hormone-sensitive prostate cancer has long been debated. A pooled analysis of randomized studies to evaluate these strategies was conducted. The results of the present analysis indicate that a docetaxele-androgen deprivation therapy combination is associated with prolonged overall survival in patients with metastatic hormone-sensitive prostate cancer. Background: A meta-analysis of the efficacy of chemohormonal regimens versus standard therapy in the management of advanced hormone-sensitive prostate cancer was conducted. Materials and Methods: The eligible studies included randomized studies evaluating chemohormonal regimens in the setting of high-risk localized or metastatic hormone-sensitive prostate cancer. Results: The search strategy yielded 900 potentially relevant citations from the searched databases. After exclusion of the ineligible studies, 10 studies were included in the qualitative analysis, among which 5 studies that had evaluated a docetaxel-hormonal therapy combination were included in the final quantitative analysis. For metastatic hormone-sensitive disease, the pooled hazard ratio (HR) for progression-free survival (PFS) was 0.63 (95% confidence interval [CI], 0.57-0.70; P < .00001), and the pooled HR for overall survival (OS) was 0.75 (95% CI, 0.65-0.86; P = .0001). For high-risk localized disease, the pooled HR for PFS was 0.68 (95% CI, 0.58-0.80; P < .00001), and the pooled HR for OS was 0.83 (95% CI, 0.61-1.13; P = .23). Conclusion: The results of the present meta-analysis have demonstrated that docetaxel-hormonal regimens are associated with superior OS and PFS in patients with metastatic disease and superior PFS but not OS in patients with high-risk localized disease. This option should be considered strongly in fit patients with adequate performance status. (C) 2015 Elsevier Inc. All rights reserved.