对转移性激素敏感前列腺癌组合策略的网络元分析
Shan-Shan Wang1,2, Xiao-Jie Bian1,2, Jun-Long Wu1,2
1Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
Asian journal of andrology
|April 16, 2024
概括
三重疗法,包括达罗胺与多塞塔克塞尔和抗雄激素剥夺疗法 (ADT),在转移性激素敏感前列腺癌 (mHSPC) 中表现出优异的疗效. 与双重治疗方案相比,这些组合提供了改善的生存结果,可管理的安全概况.
科学领域:
- 在瘤学瘤学.
- 临床药理学 临床药理学
- 证据综合 证据综合
背景情况:
- 转移性激素敏感前列腺癌 (mHSPC) 治疗已经发展成为双重和三重疗法.
- 优化治疗策略对于改善患者的生存率和生活质量至关重要.
研究的目的:
- 在mHSPC中比较各种双重和三重疗法的疗效和安全性.
- 通过网络元分析,确定最有效的治疗方案.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆系统地搜索随机对照试验 (RCT) 的文献,直到2023年10月.
- 包括研究评估abiraterone, apalutamide, enzalutamide, docetaxel, darolutamide和ADT在双重或三重组合中的研究.
- 网络元分析使用SUCRA (Surface Under the Cumulative Ranking) 来对治疗的有效性和安全性进行排名.
主要成果:
- 使用达洛胺,多塞塔克塞尔和ADT的三重疗法表明,SUCRA的总生存率最高 (84.3).
- 三重疗法还显示出更高的无进展生存率 (PFS),抗割的前列腺癌 (CRPC) 的无生存率,以及症状骨事件 (SSE) 的时间.
- 三重疗法等级>3的不良事件与多塞塔塞尔加ADT可比,表明可接受的安全性.
结论:
- 三重疗法,特别是包括达洛胺,多塞和ADT在内的三重疗法,在mHSPC中提供了增强的疗效.
- 基于达洛胺的三重疗法可能是mHSPC患者的最佳治疗选择.
- 需要进一步的研究来证实这些发现,考虑到一些纳入研究中的偏差风险.
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