Meta-Analyses and Systematic Reviews (Own Experience) in Prostate Cancer
摘要
This chapter presents meta-analyses and network meta-analyses (NMA) of randomized controlled clinical trials (RCTs) where I have acted as coauthor. Own examples of focal prostate cancer were related to radiation therapy and active surveillance. It was found that a focal boost to the dominant intraprostatic lesion (DIL) which is often the site of local recurrence after EBRT is a relevant treatment option. Similarly, in the follow-up, ultrasensitive PSA assays significantly enhance early detection of recurrence, and timely salvage radiotherapy at low PSA levels (<50 ng/L) improves survival outcomes for prostate cancer patients after radical prostatectomy. In metastatic disease, our meta-analyses show that already retrospective studies with 177Lu-PSMA RLT had better effects and caused less adverse effects than newest third-line treatments. RCTs with 177Lu-PSMA RLT in a NMA highlighted that PRLT is a highly effective and comparatively safe third-line treatment option for mCRPC, demonstrating superior outcomes in PSA response and progression-free survival and slight improvements in overall survival. Additionally, out of PARP inhibitors, olaparib may offer a best advantageous combination of improved PFS and a favorable safety profile for mCRPC patients.