title: The efficacy and safety of zibotentan in the treatment of castration-resistant prostate cancer: a meta-analysis.
abstract: OBJECTIVE
  Recently, novel endothelins like zibotentan and atrasentan and other novel taxanes have been introduced to treat prostate cancer. This study reviews zibotentan in the treatment of castration-resistant prostate cancer (CRPC) and derives a more precise estimate of their effect of treatment.
  
  
  METHODS
  Two reviewers searched and extracted data of the published trials and review articles on zibotentan for prostate cancer using the Medline, Embase and Cochrane Controlled Trials Register database. We used hazard ratios (HRs) to assess the effects on overall survival (OS), progression-free survival (PFS), or time to PSA progression (TTP), and relative risk (RR) for the different types of toxicity. Four randomized controlled trials were identified.
  
  
  RESULTS
  The pooled HR showed that zibotentan did not improve OS and PFS (HR = 0.92, 95%CI = 0.82-1.03, p = 0.161, HR = 0.98, 95% CI = 0.89-1.08, p = 0.714). Zibotentan had modest benefits on TTP (HR = 0.94, 95% CI = 0.91-0.97, p = 0.001). In addition, zibotentan led to more peripheral edema, anemia, cardiac failure and pneumonia.
  
  
  CONCLUSIONS
  Our study concludes that zibotentan is not an attractive option for CRPC patients. However, additional studies on other novel therapies are needed to improve patient outcomes.
authors.affiliation: Department of Urology, Second People's Hospital of Wuxi, Nanjing Medical University, WuXi, China. ninghan.feng@njmu.edu.cn.
authors.forename: Y
authors.initials: Y
authors.lastname: Wu
authors.forename: N
authors.initials: N
authors.lastname: Shao
authors.forename: Z-X
authors.initials: ZX
authors.lastname: Shen
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: C
authors.initials: C
authors.lastname: Li
authors.forename: G
authors.initials: G
authors.lastname: Ma
authors.forename: J
authors.initials: J
authors.lastname: Dong
authors.forename: X-J
authors.initials: XJ
authors.lastname: Lu
authors.forename: N-H
authors.initials: NH
authors.lastname: Feng
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy*; D011759:Pyrrolidines / Q000008:administration & dosage* / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis
chemical_list: D011759:Pyrrolidines; C511404:ZD4054