Cognition and depression effects of androgen receptor axis-targeted drugs in men with prostate cancer: A systematic review
| Autor: | Kevin T. Nead, Ardeshir Z. Hashmi, Eric Winquist, Michele Marchioni, Joseph L. Chin, Alicia K. Morgans, Peter E. Lonergan, Anupam Batra, Paul L. Nguyen |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty Bicalutamide Context (language use) Placebo law.invention 03 medical and health sciences chemistry.chemical_compound Prostate cancer 0302 clinical medicine Cognition Randomized controlled trial law Internal medicine Medicine Enzalutamide Humans 030212 general & internal medicine Aged business.industry Depression Apalutamide medicine.disease Prostatic Neoplasms Castration-Resistant Darolutamide Treatment Outcome chemistry Pharmaceutical Preparations Receptors Androgen 030220 oncology & carcinogenesis Geriatrics and Gerontology business medicine.drug |
| Zdroj: | Journal of geriatric oncology. 12(5) |
| ISSN: | 1879-4076 |
| Popis: | Context Novel androgen receptor axis-targeting drugs (ARATs) have been shown to improve outcomes in men with prostate cancer. Central nervous system androgen blockade may be harmful for older adults who may be at increased risk of adverse cognitive and psychologic effects. Objective To systematically evaluate the effect of ARATs on cognition and depression in men with metastatic prostate cancer. Evidence acquisition We searched PubMed and EMBASE for articles published in English between September 2012 and September 2019 reporting cognition and depression outcomes in men receiving ARATs for metastatic prostate cancer using validated psychometric tools. The level of evidence and risk of bias were assessed using the GRADE approach for randomized clinical trials and observational studies. Results 15 reports studying 8954 men with metastatic castration-sensitive and -resistant, or non-metastatic castration-resistant prostate cancer were identified. Data were available for abiraterone, enzalutamide and apalutamide but not darolutamide. The mean (and 95% confidence interval) and median (and min-max) of the absolute scores and changes from baseline were included, when available. There was heterogeneity in the psychometric tools used which obviated statistical pooling of results. Very limited data assessing cognition suggested that abiraterone was associated with improved cognitive functioning or perhaps less cognitive harm versus enzalutamide. Fourteen reports assessed emotional wellbeing. ARATs reduced depressive symptoms when compared to prednisone alone or placebo but not compared to bicalutamide. Abiraterone may improve short-term emotional functioning relative to enzalutamide. The quality of evidence was low when examining ARAT effect on cognitive function and moderate when examining ARAT effect on depression. Conclusions Depression was assessed more frequently than cognition in men receiving ARATs. Self-reported depression measures favored abiraterone over enzalutamide and both abiraterone and enzalutamide over placebo. Data evaluating apalutamide and darolutamide are lacking. Further studies of ARATs using validated clinician-based psycho-cognition tools along with self-reported measures in men with metastatic prostate cancer are needed. |
| Databáze: | OpenAIRE |
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