Evidence map›Paper›PMID 33603235›Full record

SynthesisProstate cancer and prostatic diseases2021

PSA response to antiandrogen withdrawal: a systematic review and meta-analysis.

Alwin Soo, Michael E O'Callaghan, Tina Kopsaftis, Sina Vatandoust, Kim Moretti, Ganessan Kichenadasse

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Prostate cancer and prostatic diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Alwin SooSchool of Medicine, Flinders University, Bedford Park, SA, Australia.
Michael E O'CallaghanSouth Australian Prostate Cancer Clinical Outcomes Collaborative, Flinders Medical Centre, Bedford Park, SA, Australia.
Tina KopsaftisSouth Australian Prostate Cancer Clinical Outcomes Collaborative, Flinders Medical Centre, Bedford Park, SA, Australia.
Sina VatandoustSchool of Medicine, Flinders University, Bedford Park, SA, Australia.
Kim MorettiSouth Australian Prostate Cancer Clinical Outcomes Collaborative, Flinders Medical Centre, Bedford Park, SA, Australia.ORCID http://orcid.org/0000-0002-6712-6551
Ganessan KichenadasseSchool of Medicine, Flinders University, Bedford Park, SA, Australia. ganessan.kichenadasse@flinders.edu.au.ORCID http://orcid.org/0000-0001-9923-5149
Flinders University · AUFlinders Medical Centre · AUUniversity of South Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntiandrogen withdrawal (AAW) response is the paradoxical decrease in prostate-specific antigen (PSA) following the withdrawal of antiandrogen in patients with advanced prostate cancer. Currently, the reported literature on the proportion of patients exhibiting AAW response and the differences in PSA response between the types of antiandrogens is unclear.

methodsThis review aimed to explore the PSA response to AAW and to identify if the response depends on the type of antiandrogens. A literature search was performed using databases PubMed, Cochrane and EMBASE with a cut-off date of 23rd of November 2020. Studies reporting on outcomes of AAW and prostate cancer were included. Studies were screened by two reviewers and relevant data extracted. Meta-analysis of outcomes was reported using random-effects and fixed-effects model. A subgroup analysis was performed for type of antiandrogen.

resultsFrom 450 studies, 23 were included with a total of 1474 patients with advanced prostate cancer were available for further analysis. Overall, 395 (26%) patients had any reduction in PSA levels (95% CI: 20-32%) and 183 (11%) patients had a ≥50% reduction in PSA levels (95% CI: 6-16%). Among the 1212 patients on first-generation antiandrogens, 30% (95% CI: 23-38%) had any PSA decline with 15% patients having a ≥50% PSA decline (95% CI: 8-22%). In contrast, among the 108 patients on second-generation antiandrogens, 7% (95% CI: 0-13%) had any PSA decline and only 1% (95% CI: 0-5%) had a ≥50% PSA decline. Also, among the 154 patients on androgen synthesis inhibitors, 26% (95% CI: 19-33%) had any PSA decline and only 4% (95% CI: 0-13%) had a ≥50% PSA decline.

conclusionsOne-fourth of patients treated with AAW show a PSA response. However, PSA response to AAW is uncommon with second-generation antiandrogens and androgen synthesis inhibitors. Further research is required to understand the differences in response between the types of antiandrogen.

Indexed as

Androgen AntagonistsHumansMaleProstate-Specific AntigenProstatic NeoplasmsTreatment OutcomeWithholding TreatmentAndrogen AntagonistsProstate-Specific Antigen

Identifiers

PMID33603235
OpenAlexW3129509896

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.