Combined Chemohormonal Strategy in Hormone-Sensitive Prostate Cancer: A Pooled Analysis of Randomized Studies.

BACKGROUND A meta-analysis of the efficacy of chemohormonal regimens versus standard therapy in the management of advanced hormone-sensitive prostate cancer was conducted. MATERIALS AND METHODS The eligible studies included randomized studies evaluating chemohormonal regimens in the setting of high-risk localized or metastatic hormone-sensitive prostate cancer. RESULTS The search strategy yielded 900 potentially relevant citations from the searched databases. After exclusion of the ineligible studies, 10 studies were included in the qualitative analysis, among which 5 studies that had evaluated a docetaxel-hormonal therapy combination were included in the final quantitative analysis. For metastatic hormone-sensitive disease, the pooled hazard ratio (HR) for progression-free survival (PFS) was 0.63 (95% confidence interval [CI], 0.57-0.70; P < .00001), and the pooled HR for overall survival (OS) was 0.75 (95% CI, 0.65-0.86; P = .0001). For high-risk localized disease, the pooled HR for PFS was 0.68 (95% CI, 0.58-0.80; P < .00001), and the pooled HR for OS was 0.83 (95% CI, 0.61-1.13; P = .23). CONCLUSION The results of the present meta-analysis have demonstrated that docetaxel-hormonal regimens are associated with superior OS and PFS in patients with metastatic disease and superior PFS but not OS in patients with high-risk localized disease. This option should be considered strongly in fit patients with adequate performance status.