Systemic therapies for metastatic hormone-sensitive prostate cancer: network meta-analysis
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Systemic therapies for metastatic hormone-sensitive prostate cancer: network meta-analysis. / Mori, Keiichiro; Mostafaei, Hadi; Sari Motlagh, Reza; Pradere, Benjamin; Quhal, Fahad; Laukhtina, Ekaterina; Schuettfort, Victor M; Kramer, Gero; Abufaraj, Mohammad; Karakiewicz, Pierre I; Kimura, Takahiro; Egawa, Shin; Shariat, Shahrokh F.
in: BJU INT, Jahrgang 129, Nr. 4, 04.2022, S. 423-433.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Systemic therapies for metastatic hormone-sensitive prostate cancer: network meta-analysis
AU - Mori, Keiichiro
AU - Mostafaei, Hadi
AU - Sari Motlagh, Reza
AU - Pradere, Benjamin
AU - Quhal, Fahad
AU - Laukhtina, Ekaterina
AU - Schuettfort, Victor M
AU - Kramer, Gero
AU - Abufaraj, Mohammad
AU - Karakiewicz, Pierre I
AU - Kimura, Takahiro
AU - Egawa, Shin
AU - Shariat, Shahrokh F
N1 - © 2021 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.
PY - 2022/4
Y1 - 2022/4
N2 - OBJECTIVES: To perform a systematic review and network meta-analysis to compare the efficacy and safety of currently available treatments for the management of metastatic hormone-sensitive prostate cancer (mHSPC), as there has been a paradigm shift with the use of next-generation androgen receptor inhibitors (ARIs) and docetaxel.METHODS: Multiple databases were searched for articles published before May 2020 according to the Preferred Reporting Items for Systematic Review and Meta-analysis extension statement for network meta-analysis. Studies comparing overall/progression-free survival (OS/PFS) and/or adverse events (AEs) in patients with mHSPC were eligible.RESULTS: Nine studies (N = 9960) were selected, and formal network meta-analyses were conducted. Abiraterone (hazard ratio [HR] 0.83, 95% credible interval [CrI] 0.76-0.90), docetaxel (HR 0.90, 95% CrI 0.82-0.98), and enzalutamide (HR 0.85, 95% CrI 0.73-0.99) were associated with significantly better OS than androgen-deprivation therapy (ADT), and abiraterone emerged as the best option. Abiraterone (HR 0.71, 95% CrI 0.67-0.76), apalutamide (HR 0.73, 95% CrI 0.65-0.81), docetaxel (HR 0.84, 95% CrI 0.78-0.90), and enzalutamide (HR 0.67, 95% CrI 0.63-0.71) were associated with significantly better PFS than ADT, and enzalutamide emerged as the best option. Abiraterone (HR 0.85, 95% CrI 0.78-0.93), apalutamide (HR 0.87, 95% CrI 0.77-0.98), and enzalutamide (HR 0.80, 95% CrI 0.73-0.88) were significantly more effective than docetaxel. Regarding AEs, apalutamide was the likely best option among the three ARIs. In patients with low-volume mHSPC, enzalutamide was the best option in terms of OS and PFS.CONCLUSIONS: All three ARIs are effective therapies for mHSPC; apalutamide was the best tolerated. All three seemed more effective than docetaxel. These findings may facilitate individualised treatment strategies and inform future comparative trials.
AB - OBJECTIVES: To perform a systematic review and network meta-analysis to compare the efficacy and safety of currently available treatments for the management of metastatic hormone-sensitive prostate cancer (mHSPC), as there has been a paradigm shift with the use of next-generation androgen receptor inhibitors (ARIs) and docetaxel.METHODS: Multiple databases were searched for articles published before May 2020 according to the Preferred Reporting Items for Systematic Review and Meta-analysis extension statement for network meta-analysis. Studies comparing overall/progression-free survival (OS/PFS) and/or adverse events (AEs) in patients with mHSPC were eligible.RESULTS: Nine studies (N = 9960) were selected, and formal network meta-analyses were conducted. Abiraterone (hazard ratio [HR] 0.83, 95% credible interval [CrI] 0.76-0.90), docetaxel (HR 0.90, 95% CrI 0.82-0.98), and enzalutamide (HR 0.85, 95% CrI 0.73-0.99) were associated with significantly better OS than androgen-deprivation therapy (ADT), and abiraterone emerged as the best option. Abiraterone (HR 0.71, 95% CrI 0.67-0.76), apalutamide (HR 0.73, 95% CrI 0.65-0.81), docetaxel (HR 0.84, 95% CrI 0.78-0.90), and enzalutamide (HR 0.67, 95% CrI 0.63-0.71) were associated with significantly better PFS than ADT, and enzalutamide emerged as the best option. Abiraterone (HR 0.85, 95% CrI 0.78-0.93), apalutamide (HR 0.87, 95% CrI 0.77-0.98), and enzalutamide (HR 0.80, 95% CrI 0.73-0.88) were significantly more effective than docetaxel. Regarding AEs, apalutamide was the likely best option among the three ARIs. In patients with low-volume mHSPC, enzalutamide was the best option in terms of OS and PFS.CONCLUSIONS: All three ARIs are effective therapies for mHSPC; apalutamide was the best tolerated. All three seemed more effective than docetaxel. These findings may facilitate individualised treatment strategies and inform future comparative trials.
KW - Androgen Antagonists/adverse effects
KW - Androgen Receptor Antagonists
KW - Docetaxel/therapeutic use
KW - Hormones
KW - Humans
KW - Male
KW - Network Meta-Analysis
KW - Prostatic Neoplasms/pathology
U2 - 10.1111/bju.15507
DO - 10.1111/bju.15507
M3 - SCORING: Review article
C2 - 34171173
VL - 129
SP - 423
EP - 433
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 4
ER -
