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Do disease status and race affect the efficacy of zoledronic acid in patients with prostate cancer? A systematic review and meta-analysis of randomized control trials

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  • Chiwei Chen
  • Mandi Lin
  • Daocheng Yu
  • Weiting Qin
  • Jianfu Zhou
  • Lang Guo
  • Renlun Huang
  • Xinxiang Fan
  • Songtao Xiang

Abstract

Background: Zoledronic acid (ZA) does not improve the overall survival (OS) of metastatic castration-resistant prostate cancer (mCRPC); however, little is known about the efficacy of ZA in to hormone-sensitive prostate cancer (HSPC), metastatic hormone-sensitive prostate cancer (mHSPC), and non- metastatic castration-resistant prostate cancer (nmCRPC). Therefore, we assessed the efficacy of ZA in patients with prostate cancer (PCa) and different disease statuses. Methods: Fifteen eligible randomized-control trials (RCTs) with ZA intervention, including 8280 participants with HSPC, mHSPC, nmCRPC, and mCRPC, were analyzed. The primary and secondary outcome were overall survival(OS), and skeletal-related events (SREs), and bone mineral density (BMD). Results: The participants included 8280 men (7856 non-Asian and 424 Asian). Seven trials yielded a pooled hazard ratio (HR) of 0.95 (0.88, 1.03; P = 0.19) for OS. Subgroup analysis revealed no significant improvement in OS in the HSPC, castration-resistant prostate cancer (CRPC), M0 and M1(bone metastasis) groups, with pooled HR (95%CI) of 0.96 (0.88,1.05), 0.78 (0.46,1.33), 0.95 (0.81,1.13), 0.85 (0.69,1.04) respectively. The Asian group exhibited improved in OS with an HR of 0.67 (0.48, 0.95; P = 0.02), whereas the non-Asian group showed no improvement in OS with an HR of 0.97 (0.90, 1.06; P = 0.52). Five trials yielded pooled odds ratio (OR) of 0.65 (0.45, 0.95; P = 0.02) for SREs. In the subgroup, SREs were significantly decreased in the M1 and Asian groups with ORs of 0.65 (0.45, 0.95; P = 0.02) and 0.42 (0.24, 0.71; P = 0.001), respectively. Six trials yielded a pooled mean difference (MD) of 8.08 (5.79, 10.37; P

Suggested Citation

  • Chiwei Chen & Mandi Lin & Daocheng Yu & Weiting Qin & Jianfu Zhou & Lang Guo & Renlun Huang & Xinxiang Fan & Songtao Xiang, 2022. "Do disease status and race affect the efficacy of zoledronic acid in patients with prostate cancer? A systematic review and meta-analysis of randomized control trials," PLOS ONE, Public Library of Science, vol. 17(9), pages 1-17, September.
    • Handle: RePEc:plo:pone00:0275176
    DOI: 10.1371/journal.pone.0275176
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    References listed on IDEAS

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    1. Jinsheng Zhao & Shimiao Zhu & Libin Sun & Fanzheng Meng & Lin Zhao & Yusheng Zhao & Hao Tian & Ping Li & Yuanjie Niu, 2014. "Androgen Deprivation Therapy for Prostate Cancer Is Associated with Cardiovascular Morbidity and Mortality: A Meta-Analysis of Population-Based Observational Studies," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-9, September.
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