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Systematic overview (meta-analysis) of all randomized trials of treatment of prostate cancer

Objective

To obtain the most reliable data in the treatment of prostate cancer by conducting a Systematic Overview (meta-analysis) of all randomized trials performed in the field.
To put into evidence areas in the treatment of prostate cancer requiring further research.
To maintain International collaboration amongst EU investigators in prostate cancer to combine National research efforts, harmonize treatment modalities and stimulate collaboration in large randomized clinical trials.
To widely communicate the results to the European medical community.

Prostate cancer is the second most common cancer among men in the European Union with over 85,000 new cases diagnosed every year. Treatment for different stages of disease varies widely across EU member states. In the past three decades several therapeutic questions have been studied in randomized clinical trials. In a study performed in 1992, based on medical literature, 155 randomized trials in prostate cancer were identified. The study revealed that the number of patients entered in prostate trials was insufficient (often 50-150 patients per arm) to put into evidence the size of benefits which could realistically be associated with the treatment investigated. Therefore most of the individual trials have not yielded results convincing enough to establish superior treatments or to reliably make a distinction between no worthwhile treatment effect and realistic treatment effects which are essentially moderate. Given the large number of males that will eventually develop prostate cancer, even moderate effects could represent the avoidance of several thousands of deaths in the EU. In the 80's a method proposed by R. Peto, (CTSU in Oxford), known as Systematic Overviews, based on individual patient data (or meta-analysis) was successfully applied to early breast cancer. That overview established the role of different adjuvant treatments in breast cancer. The Biometrics Department of the Netherlands Cancer Institute in association with the CTSU coordinated an overview on the question of maximal androgen blockade (MAB) versus castration alone in prostate cancer. The Prostate Cancer Trialists' Collaborative Group (PCTCG) was formed to identify studies and make the data available.
Obviously the MAB question is only one of the still controversial aspects of treatment addressed in randomized studies and a complete systematic overview is warranted. Overviews not only provide a way to analyse data from studies, thus increasing the power and the reliability of results, but also identifies further directions of research. The dissemination of the results of the overview will stimulate collaboration among the medical community within the EU and is likely to result in a more harmonized treatment policy for patients.

Funding Scheme

CON - Coordination of research actions

Coordinator

Nederlands Kanker Instituut
Address
121,Plesmanlaan
1066 CX Amsterdam
Netherlands