Feb 18, 2019
Treatment options for metastatic prostate cancer assessed in Norway in February 2020
In February 2020, the Norwegian Institute of Public Health (NIPH) has released a systematic review regarding the treatment options for metastatic prostate cancer that aimed to summarize findings of the effectiveness of androgen suppression therapy, chemotherapy, radiation and radioactive treatment in addition to standard care for metastatic prostate cancer.

The following conclusions were provided by NIPH:
  • Maximal androgen blockade compared to monotherapy probably improves survival slightly at two and five years follow up
  • Taxane-based chemohormonal therapy with standard care compared to standard care alone in hormone-sensitive phase probably reduces prostate-cancer specific death, may increase the quality of life (one year follow up) and adverse events (four years follow up)
  • Chemotherapy (Prednisone plus Cabazitaxel) plus standard care compared to other chemotherapy (Prednisone plus Mitroxantrone) plus standard care in castration-resistant patients:
    • Probably reduces death during the study (2.5 years)
    • May make little or no difference in pain
    • Probably increases nausea, reduces disease progression, slightly reduces death
  • Radiotherapy plus standard care compared to standard care alone:
    • Probably make little or no difference on survival (at three years)
    • Increases urinary tract infection (at three to seven months)
  • Radioactive treatment in addition to or compared to standard care:
    • It is uncertain whether the radioactive treatment influence overall survival
    • May slightly delay symptomatic skeletal events and improve quality of life
  • Docetaxel, chemotherapy in addition to standard care may slightly increase survival
  • Active treatment with noncytotoxic agents, Abiraterone acetate plus Prednisone and Enzalutamide, and Radium 223 Dichloride (Ra-223) is associated with varying levels of improvement in health-related quality of life.

See the full health technology assessment report here.

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