Impact of prednisone on toxicities and survival in metastatic castration-resistant prostate cancer: A systematic review and meta-analysis of randomized clinical trials.
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.
Department of Biostatistics, University of Alabama, Birmingham (UAB), AL, USA.
Charity J
CJ
Morgan
Mt. Sinai Tisch Cancer Institute, New York, NY, USA.
William K
WK
Oh
Department of Medicine, Section of Hematology-Oncology, UAB Comprehensive Cancer Center, Birmingham, AL, USA.
Gurudatta
G
Naik
Mt. Sinai Tisch Cancer Institute, New York, NY, USA.
Matthew D
MD
Galsky
Department of Medicine, Section of Hematology-Oncology, UAB Comprehensive Cancer Center, Birmingham, AL, USA. Electronic address: gsonpavde@uabmc.edu.
Guru
G
Sonpavde
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011241:Prednisone / Q000008:administration & dosage; D016016:Proportional Hazards Models; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic
D011241:Prednisone
Clinical trial; Meta-analysis; Metastatic castration-resistant prostate cancer; Prednisone; Randomized; Survival; Toxicities