Treatment of Patients with Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review of Economic Evaluations

Pelloux-Prayer, Rémi; Bataillard, Thomas; Thiery‐Vuillemin, Antoine; Vincent, Alexandre; Fagnoni, Philippe; Nerich, Virginie

doi:10.1016/j.clgc.2022.04.014

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“…28 On the other hand, a recently published QOL analysis of the STAMPEDE trial showed that patient-reported QOL was significantly better in patients treated with ABI + ADT compared to DOC + ADT over a 2-year period. 29 For cost-effectiveness, several studies demonstrated that DOC + ADT for mHSPC is the most costeffective treatment strategy 30,31 ; however, quality-adjusted lifeyears assessments suggested more favorable results for ARSI combination therapies compared to DOC + ADT. 32 Further welldesigned studies with long-term cost-effectiveness, including sequential treatment cost, are warranted.…”

Section: Discussionmentioning

confidence: 99%

Docetaxel versus abiraterone for metastatic hormone‐sensitive prostate cancer with focus on efficacy of sequential therapy

et al. 2023

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Purpose: We aimed to assess the oncologic efficacy of combining docetaxel (DOC) versus abiraterone (ABI) with androgen deprivation therapy (ADT) in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC), with a focus on the efficacy of sequential therapy, in a real-world clinical practice setting. Methods:The records of 336 patients who harbored de novo high-risk mHSPC, based on the LATITUDE criteria, and had received ADT with either DOC (n = 109) or ABI (n = 227) were retrospectively analyzed. Overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), including time to castration-resistant prostate cancer (CRPC), time to 2nd-line progression (PFS2), and 2nd-and 3rd-line PFS, were compared. We used one-to-two propensity score matching to minimize the confounders. The differential efficacy of 2nd-line therapy based on agents in each arm was evaluated using the unmatched cohort as an additional interest.Results: After propensity score matching, 86 patients treated with DOC + ADT and 172 with ABI + ADT were available for analyses. The 3-year OS and CSS for DOC versus ABI were 76.2% versus 75.1% (p = 0.8) and 78.2% versus 78.6% (p = 1), respectively. There was no difference in the median PFS2 (49 vs. 43 months, p = 0.39), while the median time to CRPC in patients treated with ABI was significantly longer compared to those treated with DOC (42 vs. 22 months; p = 0.006). The median 2nd-line PFS (14 vs. 4 months, p < 0.001) and 3rd-line PFS (4 vs. 2 months, p = 0.012) were significantly better in the DOC group than in the ABI group. Among the unmatched cohort, after ABI for mHSPC, the median 2nd-line PFS did not differ between the patients treated with DOC and those treated with enzalutamide as 2nd-line therapy (both 3 months, p = 0.8).Conclusions: ADT with DOC or ABI has comparable oncologic outcomes in terms of OS, CSS, and PFS2 in patients with de novo high-risk mHSPC. Compared to DOC,

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