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Denosumab for treatment of bone metastases secondary to solid tumours : systematic review and network meta-analysis
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Ford, John A., Jones, Rob, Elders, Andrew, Mulatero, Clive, Royle, Pamela, Sharma, Pawana, Stewart, Fiona, Todd, Radha and Mowatt, G. (2013) Denosumab for treatment of bone metastases secondary to solid tumours : systematic review and network meta-analysis. European Journal of Cancer, Volume 49 (Number 2). pp. 416-430. doi:10.1016/j.ejca.2012.07.016
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Official URL: http://dx.doi.org/10.1016/j.ejca.2012.07.016
Abstract
Abstract Aim: To evaluate the evidence for denosumab for the treatment of bone metastases secondary to solid tumours and, using a network meta-analysis, indirectly compare denosumab with bisphosphonates and best supportive care.
Data sources: MEDLINE (1948 to April 2011), EMBASE (1980 to March 2011), Cochrane Library (all sections) (issue 1, 2011) and Web of Science with Conference Proceedings (1970 to May 2011) and additional meeting abstracts (2010 and 2011) were searched.
Study eligibility, participants and interventions: Only randomised controlled trials assessing denosumab, bisphosphonates or best supportive care in patients with bone metastases from any solid tumour were included.
Synthesis: Direct evidence comparing denosumab and zoledronic acid was assessed for breast
cancer, prostate cancer and other solid tumours. Denosumab was compared with pamidronate
and best supportive care through a network meta-analysis for each tumour type. The primary outcomes were time to first skeletal related event (SRE) and time to first and subsequent SRE. Secondary outcomes were skeletal morbidity rate, pain, quality of life (QoL) and overall survival.
Results: Denosumab was found to be more effective in delaying the time to first SRE and reducing the risk of first and subsequent SRE compared to zoledronic acid, placebo and pamidronate. In breast and prostate cancer, denosumab was effective in reducing skeletal morbidity rate compared with placebo. The lack of published data on pain and QoL meant that firm conclusions could not be made. Denosumab did not appear to have an affect on
overall survival.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | European Journal of Cancer | ||||
| Publisher: | Pergamon | ||||
| ISSN: | 0959-8049 | ||||
| Official Date: | January 2013 | ||||
| Dates: |
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| Volume: | Volume 49 | ||||
| Number: | Number 2 | ||||
| Page Range: | pp. 416-430 | ||||
| DOI: | 10.1016/j.ejca.2012.07.016 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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