Impact of prednisone on toxicities and survival in metastatic castration-resistant prostate cancer: A systematic review and meta-analysis of randomized clinical trials.

Abstract

We conducted a meta-analysis of randomized trials comparing regimens that included daily oral prednisone (P) in only one arm to investigate its impact on toxicities and outcomes in metastatic castration-resistant prostate cancer (mCRPC). Five trials were identified totaling 2939 patients, of whom 1471 were randomized to an arm not containing P and 1468 received therapy containing P. There was no difference between the non-P and P groups for severe toxicities (incidence rate ratio [IRR]=0.82, p=0.712, I(2)=97.9%). When examining toxicities as a reason for discontinuing therapy, the non-P groups were not different from the P groups (relative risk [RR]=1.24, p=0.413, I(2)=86.8%). The non-P groups demonstrated no difference in OS compared to the P groups (HR=1.09, p=0.531, I(2)=79.7%). The meta-analysis is limited by the trial level design and small number of trials.

• Authors: Charity J Morgan, William K Oh, Gurudatta Naik, Matthew D Galsky, Guru Sonpavde
• Journal: Critical reviews in oncology/hematology (Crit Rev Oncol Hematol) Vol. 90 Issue 3 Pg. 253-61 (Jun 2014) ISSN: 1879-0461 [Electronic] Netherlands
• PMID: 24500033 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Prednisone

Topics

• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Humans
• Male
• Odds Ratio
• Prednisone (administration & dosage)
• Proportional Hazards Models
• Prostatic Neoplasms, Castration-Resistant (drug therapy, mortality, pathology)
• Randomized Controlled Trials as Topic