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- W1570443338 abstract "Background Non‐steroidal antiandrogens and castration are the main therapy options for advanced stages of prostate cancer. However, debate regarding the value of these treatment options continues. Objectives To assess the effects of non‐steroidal antiandrogen monotherapy compared with luteinising hormone–releasing hormone agonists or surgical castration monotherapy for treating advanced stages of prostate cancer. Search methods We searched the Cochrane Prostatic Diseases and Urologic Cancers Group Specialized Register (PROSTATE), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Web of Science with Conference Proceedings, three trial registries and abstracts from three major conferences to 23 December 2013, together with reference lists, and contacted selected experts in the field and manufacturers. Selection criteria We included randomised controlled trials comparing non‐steroidal antiandrogen monotherapy with medical or surgical castration monotherapy for men in advanced stages of prostate cancer. Data collection and analysis One review author screened all titles and abstracts; only citations that were clearly irrelevant were excluded at this stage. Then, two review authors independently examined full‐text reports, identified relevant studies, assessed the eligibility of studies for inclusion, assessed trial quality and extracted data. We contacted the study authors to request additional information. We used Review Manager 5 for data synthesis and used the fixed‐effect model for heterogeneity less than 50%; we used the random‐effects model for substantial or considerable heterogeneity. Main results Eleven studies involving 3060 randomly assigned participants were included in this review. The quality of evidence is hampered by risk of bias. Use of non‐steroidal antiandrogens decreased overall survival (hazard ratio (HR) 1.24, 95% confidence interval (CI) 1.05 to 1.48, six studies, 2712 participants) and increased clinical progression (one year: risk ratio (RR) 1.25, 95% CI 1.08 to 1.45, five studies, 2067 participants; 70 weeks: RR 1.26, 95% CI 1.08 to 1.45, six studies, 2373 participants; two years: RR 1.14, 95% CI 1.04 to 1.25, three studies, 1336 participants), as well as treatment failure (one year: RR 1.19, 95% CI 1.02 to 1.38, four studies, 1539 participants; 70 weeks: RR 1.27, 95% CI 1.05 to 1.52, five studies, 1845 participants; two years: RR 1.14, 95% CI 1.05 to 1.24, two studies, 808 participants), compared with medical or surgical castration. The quality of evidence for overall survival, clinical progression and treatment failure was rated as moderate according to GRADE. Predefined subgroup analyses showed that use of non‐steroidal antiandrogens, compared with castration, was less favourable for overall survival, clinical progression (at one year, 70 weeks, two years) and treatment failure (at one year, 70 weeks, two years) in men with metastatic disease. Use of non‐steroidal antiandrogens also increased the risk for treatment discontinuation due to adverse events (RR 1.82, 95% CI 1.13 to 2.94, eight studies, 1559 participants), including events such as breast pain (RR 22.97, 95% CI 14.79 to 35.67, eight studies, 2670 participants), gynaecomastia (RR 8.43, 95% CI 3.19 to 22.28, nine studies, 2774 participants) and asthenia (RR 1.77, 95% CI 1.36 to 2.31, five studies, 2073 participants). The risk of other adverse events, such as hot flashes (RR 0.23, 95% CI 0.19 to 0.27, nine studies, 2774 participants), haemorrhage (RR 0.07, 95% CI 0.01 to 0.54, two studies, 546 participants), nocturia (RR 0.38, 95% CI 0.20 to 0.69, one study, 480 participants), fatigue (RR 0.52, 95% CI 0.31 to 0.88, one study, 51 participants), loss of sexual interest (RR 0.50, 95% CI 0.30 to 0.83, one study, 51 participants) and urinary frequency (RR 0.22, 95% CI 0.11 to 0.47, one study, 480 participants) was decreased when non‐steroidal antiandrogens were used. The quality of evidence for breast pain, gynaecomastia and hot flashes was rated as moderate according to GRADE. The effects of non‐steroidal antiandrogens on cancer‐specific survival and biochemical progression remained unclear. Authors' conclusions Currently available evidence suggests that use of non‐steroidal antiandrogen monotherapy compared with medical or surgical castration monotherapy for advanced prostate cancer is less effective in terms of overall survival, clinical progression, treatment failure and treatment discontinuation due to adverse events. Evidence quality was rated as moderate according to GRADE. Further research is likely to have an important impact on results for patients with advanced but non‐metastatic prostate cancer treated with non‐steroidal antiandrogen monotherapy. However, we believe that research is likely not necessary on non‐steroidal antiandrogen monotherapy for men with metastatic prostate cancer. Only high‐quality, randomised controlled trials with long‐term follow‐up should be conducted. If further research is planned to investigate biochemical progression, studies with standardised follow‐up schedules using measurements of prostate‐specific antigen based on current guidelines should be conducted." @default.
- W1570443338 created "2016-06-24" @default.
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- W1570443338 date "2014-06-30" @default.
- W1570443338 modified "2023-09-24" @default.
- W1570443338 title "Non-steroidal antiandrogen monotherapy compared with luteinising hormone-releasing hormone agonists or surgical castration monotherapy for advanced prostate cancer" @default.
- W1570443338 cites W1480772894 @default.
- W1570443338 cites W1504707696 @default.
- W1570443338 cites W1548496521 @default.
- W1570443338 cites W1557313228 @default.
- W1570443338 cites W1567509999 @default.
- W1570443338 cites W1579330634 @default.
- W1570443338 cites W1588816096 @default.
- W1570443338 cites W1596902544 @default.
- W1570443338 cites W1700373378 @default.
- W1570443338 cites W1927930974 @default.
- W1570443338 cites W1942680873 @default.
- W1570443338 cites W1944587527 @default.
- W1570443338 cites W1948383940 @default.
- W1570443338 cites W1965876887 @default.
- W1570443338 cites W1970493821 @default.
- W1570443338 cites W1973079077 @default.
- W1570443338 cites W1975965108 @default.
- W1570443338 cites W1976639925 @default.
- W1570443338 cites W1979412930 @default.
- W1570443338 cites W1980800735 @default.
- W1570443338 cites W1982240792 @default.
- W1570443338 cites W1983251925 @default.
- W1570443338 cites W1985040614 @default.
- W1570443338 cites W1989085569 @default.
- W1570443338 cites W1989176861 @default.
- W1570443338 cites W1993417604 @default.
- W1570443338 cites W1997958759 @default.
- W1570443338 cites W1999460129 @default.
- W1570443338 cites W1999574106 @default.
- W1570443338 cites W1999745335 @default.
- W1570443338 cites W2000496619 @default.
- W1570443338 cites W2001209876 @default.
- W1570443338 cites W2001598371 @default.
- W1570443338 cites W2003958842 @default.
- W1570443338 cites W2005287758 @default.
- W1570443338 cites W2006286039 @default.
- W1570443338 cites W2006968122 @default.
- W1570443338 cites W2007971342 @default.
- W1570443338 cites W2008795349 @default.
- W1570443338 cites W2012774668 @default.
- W1570443338 cites W2013164488 @default.
- W1570443338 cites W2013294169 @default.
- W1570443338 cites W2019482693 @default.
- W1570443338 cites W2021246163 @default.
- W1570443338 cites W2025091395 @default.
- W1570443338 cites W2025833867 @default.
- W1570443338 cites W2028542256 @default.
- W1570443338 cites W2032578583 @default.
- W1570443338 cites W2033830958 @default.
- W1570443338 cites W2035632263 @default.
- W1570443338 cites W2039849536 @default.
- W1570443338 cites W2039891043 @default.
- W1570443338 cites W2040625799 @default.
- W1570443338 cites W2041654131 @default.
- W1570443338 cites W2044823861 @default.
- W1570443338 cites W2046635825 @default.
- W1570443338 cites W2047119194 @default.
- W1570443338 cites W2047282759 @default.
- W1570443338 cites W2047510364 @default.
- W1570443338 cites W2047573117 @default.
- W1570443338 cites W2053667183 @default.
- W1570443338 cites W2055639764 @default.
- W1570443338 cites W2056103234 @default.
- W1570443338 cites W2056387366 @default.
- W1570443338 cites W2058066455 @default.
- W1570443338 cites W2058187808 @default.
- W1570443338 cites W2059218353 @default.
- W1570443338 cites W2060779000 @default.
- W1570443338 cites W2060825762 @default.
- W1570443338 cites W2061554699 @default.
- W1570443338 cites W2062335876 @default.
- W1570443338 cites W2062725406 @default.
- W1570443338 cites W2066063754 @default.
- W1570443338 cites W2067032263 @default.
- W1570443338 cites W2073300352 @default.
- W1570443338 cites W2073336624 @default.
- W1570443338 cites W2073373703 @default.
- W1570443338 cites W2074061641 @default.
- W1570443338 cites W2074318061 @default.
- W1570443338 cites W2075132107 @default.
- W1570443338 cites W2075642745 @default.
- W1570443338 cites W2077970198 @default.
- W1570443338 cites W2079213131 @default.
- W1570443338 cites W2081052928 @default.
- W1570443338 cites W2082541377 @default.
- W1570443338 cites W2082966382 @default.
- W1570443338 cites W2085036928 @default.