title: Immunotherapy and endothelin receptor antagonists for treatment of castration-resistant prostate cancer.
abstract: Recently, novel therapies of prostate cancer, such as immunotherapy, endothelin receptor antagonists, novel androgen receptor antagonist and novel taxanes, and others have been introduced into clinical practice. This study was performed to summarize these results of immunotherapy and endothelin receptor antagonists in the treatment of castration-resistant prostate cancer (CRPC) and derive a more precise estimation of their effect on future treatment. The PubMed database, references of published trials, and review articles were searched. Two reviewers independently extracted data of these trials. We used hazard ratios (HRs) to assess the effects on overall survival (OS), progression-free survival (PFS), or time to disease progression (TTP), and relative risk (RR) for the different types of toxicity. In addition, 95% confidence intervals (CIs) give a sense of the precision of the estimate. Nine randomized controlled trials were ultimately identified. The pooled HR showed that immunotherapy could prolong OS significantly in patients with CRPC compared to placebo (HR = 0.70, 95% CI: 0.58-0.83, p < 0.001). Endothelin receptor antagonists also had modest benefits (HR = 0.90, 95% CI: 0.82-1.00, p = 0.046). Nevertheless, there were no significant benefits from both therapies on PFS or TTP. In addition, immunotherapy led to more fatigue, pyrexia, chills, and endothelin receptor antagonists led to more peripheral edema, anemia, and dyspnea. Our article suggested that the very acceptable toxicity and improving OS in patients with CRPC made immunotherapy an attractive option for such patients. However, future studies with thoughtful clinical trial designs are warranted.
authors.affiliation: Department of Urology, Jiangsu Province Geriatric Hospital, Nanjing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Shao
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Wen Yu
authors.initials: WY
authors.lastname: Jiang
authors.forename: Di
authors.initials: D
authors.lastname: Qiao
authors.forename: Shi Ge
authors.initials: SG
authors.lastname: Zhang
authors.forename: Ye
authors.initials: Y
authors.lastname: Wu
authors.forename: Xiang Xiang
authors.initials: XX
authors.lastname: Zhang
authors.forename: Jiu Ling
authors.initials: JL
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Ding
authors.forename: Ning Han
authors.initials: NH
authors.lastname: Feng
mesh_terms: D000077868:Atrasentan; D018572:Disease-Free Survival; D065128:Endothelin Receptor Antagonists; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D009919:Orchiectomy; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D011759:Pyrrolidines / Q000009:adverse effects / Q000627:therapeutic use; D014020:Tissue Extracts / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D065128:Endothelin Receptor Antagonists; D011759:Pyrrolidines; D014020:Tissue Extracts; C511404:ZD4054; C511774:sipuleucel-T; D000077868:Atrasentan
keywords: CRPC; endothelin receptor antagonists; immunotherapy