International study into the use of intermittent hormone therapy in the treatment of carcinoma of the prostate: A meta-analysis of 1446 patients

Greg L. Shaw, Peter Wilson, Jack Cuzick, David M. Prowse, S. Larry Goldenberg, Nigel A. Spry, Tim Oliver

Research output: Contribution to journalArticlepeer-review

89 Citations (Scopus)
159 Downloads (Pure)

Abstract

OBJECTIVE: To review pooled phase II data to identify features of different regimens of intermittent hormone therapy (IHT), developed to reduce the morbidity of treating metastatic prostate cancer, and which carries a theoretical advantage of delaying the onset of androgen-independent prostate cancer, (AIPC) that are associated with success, highlighting features which require exploration with prospective trials to establish the best strategies for using this treatment. METHODS: Individual data were collated on 1446 patients with adequate information, from 10 phase II studies with >50 cases, identified through Pubmed. RESULTS: Univariate and multivariate Cox proportional hazard models were developed to predict treatment success with a high degree of statistical success. The prostate-specific antigen (PSA) nadir, the PSA threshold to restart treatment, and medication type and duration, were important predictors of outcome. CONCLUSIONS: The duration of biochemical remission after a period of HT is a durable early indicator of how rapidly AIPC and death will occur, and will make a useful endpoint in future trials to investigate the best ways to use IHT based on the important treatment cycling variables described above. Patients spent a mean of 39% of the time off treatment. The initial PSA level and PSA nadir allow the identification of patients with prostate cancer in whom it might be possible to avoid radical therapy.

Original languageEnglish
Pages (from-to)1056-1065
Number of pages10
JournalBJU International
Volume99
Issue number5
DOIs
Publication statusPublished - 1 May 2007

Keywords

  • Intermittent hormone treatment
  • Meta-analysis
  • Prostate cancer

Fingerprint

Dive into the research topics of 'International study into the use of intermittent hormone therapy in the treatment of carcinoma of the prostate: A meta-analysis of 1446 patients'. Together they form a unique fingerprint.

Cite this