Published online Jun 26, 2016. doi: 10.13105/wjma.v4.i3.69
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
Processing time: 165 Days and 3 Hours
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.
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.