Clinical question
How effective is taxane-based chemohormonal therapy for newly diagnosed, metastatic, hormone-sensitive prostate cancer?
Bottom line
Compared with systemic androgen deprivation therapy alone, the early (within 120 days of beginning ADT) addition of TBCT to ADT for newly diagnosed, metastatic, hormone‐sensitive prostate cancer prolonged both overall and disease‐specific survival and delayed disease progression. There was an increase in toxicity with TBCT in combination with ADT. There was also a small, clinically unimportant improvement in quality of life at 12 months with TBCT and ADT treatment.
Caveat
The certainty of the evidence for time to death from any cause, risk of prostate cancer‐specific death and the time to disease progression was moderate. The certainty of the evidence was low for adverse events of all grades, people stopping treatment due to adverse events, and quality of life.
Context
Of men diagnosed with prostate cancer, approximately 16% present with cancer that has spread at diagnosis. In addition, another 15% to 30% of men get the disease again after having primary treatment. Hormone therapy has been the first treatment for advanced cancer, but it does not cure it, and eventually the cancer comes back. Recently, studies have looked at whether chemotherapy, when given early, can improve outcomes.
Cochrane Systematic Review
Cochrane Systematic Review Sathianathen NJ et al. Taxane-based chemohormonal therapy for metastatic hormone-sensitive prostate cancer. Cochrane Reviews, 2019, Issue 10. Art. No.: CD012816. DOI: 10.1002/14651858. CD012816.pub2. This review contains 3 studies involving 2261 participants.
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