Complete androgen blockade for prostate cancer: What went wrong?

Citation
M. Laufer et al., Complete androgen blockade for prostate cancer: What went wrong?, J UROL, 164(1), 2000, pp. 3-9
Citations number
72
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Urology & Nephrology","da verificare
Journal title
JOURNAL OF UROLOGY
ISSN journal
0022-5347 → ACNP
Volume
164
Issue
1
Year of publication
2000
Pages
3 - 9
Database
ISI
SICI code
0022-5347(200007)164:1<3:CABFPC>2.0.ZU;2-6
Abstract
Purpose: We summarized and critically assessed all available data from phas e III clinical trials on complete androgen blockade versus surgical or medi cal castration alone. Materials and Methods: Published results in journals and abstracts of phase III trials, and published meta-analyses were reviewed. We also reviewed qu ality of life and toxicity issues associated with the addition of antiandro gens to medical or surgical castration. Finally, we discuss the original ra tionale for complete androgen blockade in the context of current knowledge. Results: A total of 27 clinical trials using various combinations of androg en deprivation were identified, of which 3 showed a statistically significa nt benefit for the complete androgen blockade arm. There were 5 publication s of meta-analyses that each used different selection criteria for the incl usion of studies in the final analysis. Toxicity and quality of life have n ot been widely investigated in prospective fashion but the available data s uggest a higher toxicity rate and decreased quality of life with complete a ndrogen blockade. Conclusions: The extensive body of data does not support routine use of ant iandrogens in combination with medical or surgical castration as first line hormonal therapy in patients with metastatic prostate cancer.