Tools for predicting clinical and patient reported outcomes in prostate cancer patients undergoing androgen deprivation therapy: a systematic review of prognostic accuracy and validity

• Published in: Clinical genitourinary cancer 2017-12, Vol.15 (6), p.629-634.e8
• Main Authors: Campbell, Jared M, O’Callaghan, Michael E, Raymond, Elspeth, Vincent, Andrew D, Beckmann, Kerri R, Roder, David, Evans, Sue, McNeil, John, Millar, Jeremy, Zalcberg, John, Borg, Martin, Moretti, Kim L
• Format: Article
• Language: English
• Subjects: Androgen antagonists; Androgen Antagonists - therapeutic use; Hematology, Oncology and Palliative Medicine; Humans; Japan; Male; Neoplasm metastasis; Neoplasm Recurrence, Local - drug therapy; Nomograms; Patient Reported Outcome Measures; Prognosis; Prostatic neoplasms; Prostatic Neoplasms - drug therapy; Quality of Life; Reproducibility of Results; Urology
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2017.03.011

Abstract Background Androgen deprivation therapy (ADT) can result in a range of adverse symptoms which reduce quality of life. Careful patient counselling on likely clinical outcomes and adverse effects is therefore vital. This systematic review was undertaken to identify and characterise all tools for the prediction of clinical and patient reported outcome measures (PROMs) in patients with prostate cancer receiving ADT. Materials and methods PubMed and EMBASE were systematically searched from 2007-2016. Search terms related to the inclusion criteria: prostate cancer, clinical outcomes, PROMs, ADT and prognosis. Titles and abstracts were reviewed for relevant studies which were advanced to full-text review. Reference lists were screened for additional studies. The Centre for Evidence Based Medicine ‘Critical appraisal of prognostic studies’ tool was applied. Results The search strategy identified 8,755 studies. From these twenty-two studies on clinical outcomes were identified, however none were found on PROMs. Nine tools predicted of clinical outcomes in treatment naive patients and ten in patients with recurrence. The J-CAPRA nomogram was the best performing and validated tool for the prediction of clinical outcomes in treatment naive patients, while the Chi and Shamash prognostic indices had been validated for use in castration resistant patients in different clinical contexts. Conclusions Use of the J-CAPRA nomogram should help clinicians deliver accurate, evidence based counselling to patients undergoing primary ADT. There is a strong need for primary studies that derive and validate tools for the prediction of PROMs in patients receiving ADT under any circumstances as they are currently absent from the literature.