Switching Cancers: A Systematic Review Assessing the Role of Androgen Suppressive Therapy in Bladder Cancer
| Autor: | Alexandre R. Zlotta, Catherine McMartin, Richard T. Bryan, Paul Toren, Kassim Kourbanhoussen, Michele Lodde |
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| Přispěvatelé: | Centre Hospitalier Université Laval [Quebec] (CHUL), CHU de Québec–Université Laval, Université Laval [Québec] (ULaval)-Université Laval [Québec] (ULaval), Université Laval [Québec] (ULaval), Institute of Medical Science [Toronto], University of Toronto, Institute of Cancer and Genomic Sciences, University of Birmingham, Centre de recherche du CHU de Québec-Université Laval (CRCHUQ) |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty medicine.drug_class Urology 030232 urology & nephrology [SDV.CAN]Life Sciences [q-bio]/Cancer Antiandrogen urologic and male genital diseases Androgen suppression therapy 03 medical and health sciences Prostate cancer 0302 clinical medicine 5-alpha Reductase Inhibitors Lower urinary tract symptoms Recurrence Internal medicine medicine Humans Antiandrogen Therapy Prospective cohort study Bladder cancer business.industry Incidence Cancer Prostatic Neoplasms Androgen Antagonists medicine.disease 3. Good health Tolerability Urinary Bladder Neoplasms 030220 oncology & carcinogenesis Systematic review Androgens business Carcinoma in Situ |
| Zdroj: | European Urology Focus European Urology Focus, Elsevier, 2020, ⟨10.1016/j.euf.2020.10.002⟩ |
| ISSN: | 2405-4569 |
| DOI: | 10.1016/j.euf.2020.10.002⟩ |
| Popis: | Context Bladder cancer demonstrates striking gender-based differences in incidence, with a role for androgens possibly implicated in the development and progression of the disease. Emerging preclinical and clinical evidence suggests that there may be a role for antiandrogen therapy in bladder cancer. Objective This systematic review assessed the current clinical evidence evaluating androgen suppressive therapy (AST) for the treatment or prevention of bladder cancer. Evidence acquisition Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, MEDLINE was searched for full-text articles detailing clinical outcomes or incidence of bladder cancer among patients who received AST, defined as gonadotropin-releasing hormone agonists or equivalent, androgen receptor antagonists, or 5-alpha reductase inhibitors. Evidence synthesis A total of 12 studies were included. Five studies focused on prostate cancer patients, with one study in men with lower urinary tract symptoms. Among these studies, a lower incidence of bladder cancer was observed in five, with adjusted risk reduction estimates ranging from 7% to 47%. Six studies evaluating 11 820 bladder cancer patients investigated clinical outcomes among men who received a form of AST. Three out of four studies evaluating recurrence-free survival found a benefit for AST, with adjusted hazard ratios for recurrence of non–muscle-invasive cancer ranging from 0.29 to 0.53. Limitations included large variability in data sources and methodologies, as well as no data on tolerability. Conclusions Current evidence indicates that antiandrogen therapies exert a favorable influence on bladder tumors. Further prospective studies are needed to assess their therapeutic potential. Patient summary Androgen suppressive therapy is commonly prescribed for the treatment of prostate-related problems. Prior research indicates that there may be a role for these treatments in patients with bladder cancer. In this review, we evaluate the current evidence that strongly suggests that these agents may be effective against bladder cancer. |
| Databáze: | OpenAIRE |
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