Meta-Analysis
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Jun 26, 2016; 4(3): 69-76
Published online Jun 26, 2016. doi: 10.13105/wjma.v4.i3.69
Efficacy, safety, and dose comparison of degarelix for the treatment of prostate cancer: A systematic review and meta-analysis
Cheng Fang, Cai-Liang Wu, Sha-Sha Liu, Long Ge, Jin-Liang Bai
Cheng Fang, Jin-liang Bai, Department of Urological, First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China
Cai-Liang Wu, Department of Obstetrics and Gynecology, First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China
Sha-Sha Liu, Department of Pathology, First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China
Long Ge, Evidence-Based Medicine Center, Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Fang C and Wu CL are co-first authors; Fang C and Wu CL wrote the manuscript; Fang C and Bai JL planed and designed the research; Wu CL and Ge L tested the feasibility of the study; Ge L performed the statistical analysis; all authors approved the final version of the manuscript.
Conflict-of-interest statement: None.
Data sharing statement: We declare that we have no additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jin-Liang Bai, Professor, Department of Urological, First Clinical Medical College of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. 541301922@qq.com
Telephone: +86-931-8356807
Received: January 3, 2016
Peer-review started: January 3, 2016
First decision: February 29, 2016
Revised: March 23, 2016
Accepted: April 21, 2016
Article in press: April 22, 2016
Published online: June 26, 2016
Abstract

AIM: To conduct a systematic review and meta-analysis into the efficacy, safety, and dosage regimens of degarelix for treating prostate cancer (PCa).

METHODS: PubMed, EMBASE, the Cochrane Library, and Web of Science was systematically searched to identify randomized controlled trials (RCTs) comparing degarelix (240/80 mg vs 240/160 mg) to the gonadotropin-releasing hormone agonists, goserelin and leuprolide, for the treatment of PCa. Two independent reviewers screened putative studies, assessed the risk of bias, and then extracted pertinent data. Analyses were performed using Review Manager 5.2.

RESULTS: Seven papers from six RCTs, involving 1204 patients, were identified. The present meta-analysis showed that treatment with 240/160 mg degarelix is more effective and has fewer adverse events (AEs) relative to conventional 240/80 mg regimen. Degarelix significantly decreased International Prostate Symptom Scores [standardized mean differences (SMD) = -0.32, 95%CI: -0.51 to -0.12, P = 0.02] and caused fewer AEs (SMD = -0.28, 95%CI: -0.48 to -0.07, P = 0.008) than goserelin. Degarelix suppressed testosterone and prostate-specific antigen significantly faster than leuprolide.

CONCLUSION: Degarelix is a useful option in the treatment of advanced PCa. Degarelix 240/160 mg regimen was superior to a 240/80 mg regimen. More rigorously designed RCTs are urgently needed to confirm the efficacy of degarelix.

Keywords: Prostate cancer, Degarelix, Meta-analysis

Core tip: This meta-analysis and systematic review aimed to compare the efficacy, safety, and dosage regimens of degarelix for prostate cancer. A total of seven papers from 6 randomized controlled trials were identified, involving 1204 patients. Degarelix was an useful option in the treatment of advanced prostate cancer, and degarelix 240/160 mg regimen was superior to 240/80 mg regimen.