NDLI: Evaluation of Cognitive Function in Trials Testing New-Generation Hormonal Therapy in Patients with Prostate Cancer: A Systematic Review

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Evaluation of Cognitive Function in Trials Testing New-Generation Hormonal Therapy in Patients with Prostate Cancer: A Systematic Review

Content Provider	MDPI
Author	Marandino, Laura Vignani, Francesca Buttigliero, Consuelo Gamba, Teresa Necchi, Andrea Tucci, Marcello Maio, Massimo Di
Copyright Year	2020
Description	In patients with prostate cancer, earlier use and longer duration of new-generation hormonal therapy (NGHT), added to androgen deprivation therapy, requires careful evaluation of cognitive function. The aim of this systematic review is to describe the evidence about cognitive function in all the randomized trials (RCTs) testing NGHT (abiraterone, enzalutamide, apalutamide, darolutamide). We assessed the availability of both investigator-assessed cognitive impairment and disorders and patient-reported evaluation of cognitive function. Nineteen RCTs (17,617 patients) were included. The investigator-based evaluation of cognitive impairment was available in seven RCTs (36.8%). In total, 19/19 RCTs (100%) included patient-reported outcomes (PROs) collection, but PRO tools adopted allowed evaluation of cognitive function in two RCTs (10.5%). Among them, PRO-based cognitive function results were presented only in one RCT (5.3%): in ENZAMET, mean changes from baseline were worse with enzalutamide than with placebo, but deterioration-free survival favored enzalutamide. Despite cognitive deterioration could be relevant, clinical development of NGHT has not included a systematic evaluation of cognitive function. Assessment by investigators is at risk of underreporting, and commonly used PROs do not allow proper cognitive function analysis. Furthermore, the methodology of analysis can jeopardize the interpretation of results. Although direct comparisons are scanty, there could be differences between different NGHTs.
Starting Page	2568
e-ISSN	20726694
DOI	10.3390/cancers12092568
Journal	Cancers
Issue Number	9
Volume Number	12
Language	English
Publisher	MDPI
Publisher Date	2020-09-09
Access Restriction	Open
Subject Keyword	Cancers Urology and Nephrology Cognitive Function Prostate Cancer Abiraterone Enzalutamide Apalutamide Darolutamide
Content Type	Text
Resource Type	Article

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