A meta-analysis on individual data of bone-targeting radio-isotopes in men with bone metastases from castration-resistant prostate cancer
| العنوان: | A meta-analysis on individual data of bone-targeting radio-isotopes in men with bone metastases from castration-resistant prostate cancer |
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| المؤلفون: | Karim Fizazi, Laurence Collette, Jean-Pierre Pignon, Chris Parker, Sigbjørn Smeland, Safae Terrisse, Karamouza Eleni, A. Oliver Sartor, Gwénaël Le Teuff, Nicholas D. James, Sarah Pirrie, Bertrand F. Tombal, Jad Chahoud, Bjørn Erisktein |
| المصدر: | Journal of Clinical Oncology. 36:352-352 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Oncology, Cancer Research, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Hazard ratio, medicine.disease, law.invention, Prostate cancer, Bone targeting, Randomized controlled trial, law, Internal medicine, Meta-analysis, medicine, External beam radiotherapy, Radio isotopes, business |
| الوصف: | 352 Background: Among bone-targeted radio-isotopes (RI), Radium-223 (an α-emitter) is the only one with clearly demonstrated overall survival (OS) benefit in men with castration-resistant prostate cancer (CRPC). The aim of this meta-analysis is to estimate the OS impact of RI in men with CRPC. Methods: An individual patient data meta-analysis was carried out from randomized trials with inclusion period 1993-2013. Eligible trials included more than 50 patients, mandated bone metastases from CRPC and randomly evaluated RI. Endpoints were OS (primary), symptomatic skeletal events (SSE) and toxicity. A fixed-effect model was used. The log-rank test stratified by trial was used to estimate individual and overall hazard ratios (HR). Subset analyses were performed by the type of radiation (α vs. β emission) and by trial comparison: RI + Chemotherapy (CT) vs. CT, RI+ External beam radiotherapy (EBRT) vs. EBRT, RI vs. EBRT. Results: From 9 identified trials, data from 6 trials comprising 2081 patients (min: 64, max: 921) were collected with 2 trials representing 80% of data. The data from 3 trials (n = 341) were not available. The overall effect on OS favoured RI with HR = 0.86 [0.77-0.95] but high heterogeneity between trials (p < 0.001, I2= 79.6%). The overall effect of α- emitters on OS (HR = 0.70 [0.58; 0.83], 2 trials, n = 985) significantly differed from that of β-emitters (HR = 0.96 [0.84; 1.10], n = 4 trials, n = 1096) (interaction p = 0.0041). The overall effect on SSE favoured RI with HR = 0.81 [0.69-0.93] (4 trials, n = 1806) with marked between trial heterogeneity (p = 0.08, I² = 55.3%) and a significant difference (p = 0.02) by the type of RI (α-emitters: HR = 0.65 [0.52-0.82]-2 trials, β-emitters: HR = 0.93 [0.77-1.13]-2 trials). Conclusions: In men with metastatic CRPC a significant improvement of OS and SSE was obtained with bone targeted α-emitter radio isotopes, but not with β-emitter. However, some between trial heterogeneity of effects on OS need further investigations. |
| تدمد: | 1527-7755 0732-183X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::dafb509e72475258704096d825d8b0f4Test https://doi.org/10.1200/jco.2018.36.6_suppl.352Test |
| رقم الانضمام: | edsair.doi...........dafb509e72475258704096d825d8b0f4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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