The Efficacy And Safety Of GnRH Antagonist Degarelix For The Treatment Of Prostate Cancer:a Systematic Review And Meta-analysis

AIM: To conduct a systematic review and meta-analysis into the efficacy,safety,and dosage regimens of degarelix for treating prostate cancer(PCa).METHODS: Pub Med,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.Degarelix240/160 mg regimen was superior to a 240/80 mg regimen.More rigorously designed RCTs are urgently needed to confirm the efficacy of degarelix.