New Antiandrogen Compounds Compared to Docetaxel for Metastatic Hormone Sensitive Prostate Cancer: Results from a Network Meta-Analysis

Marchioni, Michele; Nicola, Marta Di; Primiceri, Giulia; Novara, Giacomo; Castellan, Pietro; Paul, Asit K.; Veccia, Alessandro; Autorino, Riccardo; Cindolo, Luca; Schips, Luigi

doi:10.1097/ju.0000000000000636

Cited by 47 publications

(27 citation statements)

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“…As no study directory has compared the e cacy of upfront intensive therapies, indirect comparisons using network meta-analysis support the superiority of upfront ARATs therapy over upfront DTX. [18][19][20] We found persistent decline of CRPC-free survival in the patients with upfront DTX therapy (Fig. 5A).…”

Section: Discussionmentioning

confidence: 90%

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The Effect of Upfront Intensive Therapy on Primary Resistance in Metastatic Castration-sensitive Prostate Cancer: A Multicenter Retrospective Study

Tanaka

Hatakeyama

Noro³

et al. 2021

Preprint

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We investigated the effect of upfront intensive therapy on primary resistance in patients with metastatic castration-sensitive prostate cancer (mCSPC) in real-world practice. We retrospectively evaluated the medical records of 348 patients with newly diagnosed mCSPC who had a high tumor-burden between January 2008 and May 2021. We compared the oncological outcomes between patients who received conventional androgen deprivation therapy ± bicalutamide (ADT group) and those treated with upfront intensive therapies (upfront group). The primary purpose was comparing the rate of primary resistance between the ADT and upfront groups. The primary resistance was defined as a castration-resistant prostate cancer (CRPC) progression < 6 or < 12 months. The secondary purposes were comparing the CRPC-free survival and overall survival (OS) between the ADT and upfront groups, and assessing safety in the upfront group. We identified 206 and 142 patients for the ADT and upfront groups, respectively. We found the rate of CRPC progression < 6 and < 12 months was significantly lower in the upfront group (9.2% and 18%, respectively) than that in the ADT group (21% and 51%, respectively). The upfront therapy was significantly associated with favorable CRPC-free survival and OS than that in the ADT group in propensity-score adjusted models. A higher rate of any grade adverse events was observed in the upfront docetaxel (94%) than that of the upfront abiraterone (34%) or apalutamide/enzalutamide (39%). In conclusion, the upfront intensive therapy significantly improved the rate of primary resistance and oncological outcomes in patients with mCSPC in real-world practice.

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Section: Discussionmentioning

confidence: 90%

“…The median follow-up periods in the ADT and upfront groups were 37 (IQR, 21-58) and 22 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) months, respectively. Most patients in the ADT group were treated with CAB (n = 193, 94%).…”

Section: Resultsmentioning

confidence: 99%

The Effect of Upfront Intensive Therapy on Primary Resistance in Metastatic Castration-sensitive Prostate Cancer: A Multicenter Retrospective Study

Tanaka

Hatakeyama

Noro³

et al. 2021

Preprint

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“…In this case study, duplication resulted primarily from the situation of multiple new mHSPC treatments emerging within a relatively short period of time, raising unanswered questions on multiple fronts. New therapeutic advances continue to emerge in this setting, and indeed a similar situation may already be developing [54][55][56]. Likewise, respected commentators have noted the risks of duplication in the context of COVID-19 [3], where for example the antiviral drug remdesivir has recently been the focus of multiple reviews [57][58][59].…”

Section: Discussionmentioning

confidence: 99%

Duplicated Network Meta-analysis: a Case Study and Recommendations for Change

Fisher¹,

Burdett²,

Vale³

et al. 2021

Preprint

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BackgroundResearch overlap and duplication is a recognised problem in the context of both pairwise and network systematic reviews. We carried out a systematic review to identify and examine duplicated Network Meta-Analyses (NMAs) in a specific disease setting where several novel therapies have recently emerged: hormone-sensitive metastatic prostate cancer (mHSPC).MethodsMEDLINE and EMBASE were systematically searched for indirect or mixed treatment comparisons or network meta-analyses of systemic treatments in the mHSPC setting, with a time-to-event outcome reported on the hazard-ratio scale. Eligibility decisions were made, and data extraction performed, by two independent reviewers.ResultsA total of 13 eligible reviews were identified, analysing between 3 and 8 randomised comparisons, and comprising between 1,773 and 7,844 individual patients. Although the included trials and treatments showed a high degree of overlap, we observed considerable variation between identified reviews in terms of review aims, eligibility criteria and included data, statistical methodology, reporting and inference. Furthermore, crucial methodological details and specific source data were often unclear.Conclusions and RecommendationsVariation across duplicated NMAs, together with reporting inadequacies, may compromise identification of best-performing treatments. We recommend that review protocols be published in advance, with greater clarity regarding the unique aims or scope of the project. Source data and results should be clearly and completely presented to allow unbiased interpretation. Review authors should be fully knowledgeable of their subject, both in terms of relevant studies and of other reviews with potential for overlap or duplication; and should re-evaluate their knowledge throughout the research process, particularly in fast-moving fields.

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“…In addition, they examine adverse events across the pooled studies, and found higher rates of adverse events with abiraterone and docetaxel compared to ADT, and lower rates with abiraterone and enzalutamide compared to docetaxel, with rates similar to treatment with ADT alone. 20 Although meta-analyses of this nature are limited given varying factors including patient selection across multiple studies, there will certainly be more data emerging on comparisons between agents as utilization in this disease space grows.…”

Section: Comparative Datamentioning

confidence: 99%

<p>Metastatic Hormone-sensitive Prostate Cancer: Current Perspective on the Evolving Therapeutic Landscape</p>

Hall¹,

Huelster²,

Luckenbaugh³

et al. 2020

OTT

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Introduction: The treatment landscape for patients with metastatic hormone-sensitive prostate cancer (mHSPC) has changed dramatically in the past five years, despite little change in the preceding 20 years. Such rapid change can make it difficult for clinicians to remain abreast of the current literature and synthesize the relevant data to inform evidencebased treatment decisions. Methodology: We performed a narrative, comprehensive review of treatment options for patients with mHSPC as of December 31, 2019. Specifically, we focused on phase II and III randomized controlled trials assessing the role of chemotherapy, novel androgen axis targeting agents, local-(prostate) directed therapy, and metastasis-directed therapy. Results: The data support a survival benefit with the addition of four different agents to androgen deprivation among men with newly diagnosed prostate cancer-docetaxel, abiraterone acetate, enzalutamide, and apalutamide. While not directly compared, the efficacy of these agents appears similar. That said, there are differences in their toxicity profiles and notable differences in cost between agents. Although analyses encompassing men with lowand high-volume metastases failed to demonstrate a significant survival benefit for radiotherapy treatment to the prostate, new data demonstrates a benefit for men with low-volume metastatic disease. Ongoing trials will assess whether this applies to local surgical treatment. Similarly, metastasis-directed therapy appears beneficial among carefully selected patients. Conclusion: Treatment options for patients with mHSPC are rapidly changing following years of stagnation. A number of systemic therapies offer benefit without significant clinical differences between them. The role for local treatment of the prostate as well as metastatic sites continues to evolve.

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New Antiandrogen Compounds Compared to Docetaxel for Metastatic Hormone Sensitive Prostate Cancer: Results from a Network Meta-Analysis

Cited by 47 publications

References 0 publications

The Effect of Upfront Intensive Therapy on Primary Resistance in Metastatic Castration-sensitive Prostate Cancer: A Multicenter Retrospective Study

The Effect of Upfront Intensive Therapy on Primary Resistance in Metastatic Castration-sensitive Prostate Cancer: A Multicenter Retrospective Study

Duplicated Network Meta-analysis: a Case Study and Recommendations for Change

<p>Metastatic Hormone-sensitive Prostate Cancer: Current Perspective on the Evolving Therapeutic Landscape</p>

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