What are the optimal systemic treatments for men with metastatic, hormone-sensitive prostate cancer? A STOPCaP systematic review and network meta-analysis

Vale, Claire; Fisher, David J.; Carpenter, James; White, Ian R.; Burdett, Sarah; Clarke, Noel W.; Fizazi, Karim; Gravis, G.; James, N.D.; Mason, Malcolm; Parmar, M.K.; Rydzewska, Larysa; Sweeney, Christopher J.; Spears, Melissa; Sydes, M; Tierney, Jayne

doi:10.1093/annonc/mdx440.026

Cited by 7 publications

(12 citation statements)

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“…Key findings of our analysis showed a positive OS and rPFS trend for AA þ P þ ADT vs. DOC þ ADT for both the NDx HRD ITT and NDx HRD&HVD populations from LATITUDE [2], with results being somewhat more in favour when the NDx HRD&HVD population was analysed. The OS results are in line with those of previously published meta-analyses [23,24], reinforcing the suggestion that AA þ P þ ADT is highly likely to be a better treatment than DOC þ ADT with regard to this outcome.…”

Section: Discussionsupporting

confidence: 89%

“…This research had a broader perspective than various previous pooled analyses conducted to estimate the relative efficacy of AA þ P þ ADT or DOC þ ADT compared with ADT alone [4,11e18] and other metaanalyses conducted to compare AA þ P þ ADT vs. DOC þ ADT [23,24]. Specifically, it included the following relevant data that were either not considered by or not available for these earlier analyses: unpublished subgroup data for the post hoc analysis of the NDx HRD&HVD population from LATITUDE [2] and data of the relative effects of these treatments on QoL, an important factor to weigh along with survival outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…A key question is whether AA þ P or DOC holds an advantage over the other when combined with ADT in patients with mHSPC. Two recently published indirect treatment comparisons of AA þ P þ ADT vs. DOC þ ADT [23,24] concluded that there is a high likelihood that AA þ P þ ADT is the preferred option, but the size of the survival advantage remains unclear. Crucially, however, the comparison did not include all available evidence from STAMPEDE (direct headto-head evidence on the survival benefit of AA þ P þ ADT vs. DOC þ P þ ADT) [25,26] nor did it compare the regimens' effects on quality of life (QoL).…”

Section: Introductionmentioning

confidence: 99%

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Survival benefit, disease progression and quality-of-life outcomes of abiraterone acetate plus prednisone versus docetaxel in metastatic hormone-sensitive prostate cancer: A network meta-analysis

Feyerabend¹,

Saad

et al. 2018

European Journal of Cancer

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Survival benefit, disease progression and quality-of-life outcomes of abiraterone acetate plus prednisone versus docetaxel in metastatic hormone-sensitive prostate cancer: A network meta-analysis

Feyerabend¹,

Saad

et al. 2018

European Journal of Cancer

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“…More recently, the use of abiraterone acetate and prednisone with ADT in the early castration‐sensitive setting was also shown to improve overall survival in the LATITUDE and STAMPEDE (Arm G) phase III clinical trials. There have been no prospective clinical trials comparing docetaxel and abiraterone in this setting, although some analyses show similar efficacy . However, this does not take into account challenges encountered when delivering chemotherapy in a real‐world setting.…”

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness of docetaxel for castration‐sensitive prostate cancer in a real‐world population‐based analysis

et al. 2018

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Background: Adding docetaxel to androgen deprivation therapy (ADT) for the treatment of metastatic castration-sensitive prostate cancer (mCSPC) has known efficacy, with an overall survival benefit in Phase III clinical trials. The effectiveness of docetaxel with ADT in the general patient population remains undefined. Patients and Methods:We conducted a population-based retrospective review using the British Columbia Provincial Pharmacy Database. To be included, patients had to have castration-sensitive prostate cancer not previously treated (except in the adjuvant setting) and have received at least one cycle of docetaxel, with complete records available for review. Safety and clinical effectiveness were evaluated.Results: From April 2015 to February 2017, we identified 183 cases; 156 met inclusion criteria. Most patients had high-volume disease (80%). All 6 planned docetaxel cycles were delivered in 126 cases (81%). Dose reductions and delays were required in 39% and 16% of cases. Grade 3-4 adverse events were noted in 40%, with no treatmentrelated deaths. The rate of febrile neutropenia was 18% and was significantly associated with the presence of high-volume disease (P = 0.038). PSA ≤ 0.2 ng/L was achieved in 27% of patients after 6 months of ADT and maintained in 16% after 12 months. Patients with over 20 bone metastases had worse time to castration resistant prostate cancer (CRPC) and time to treatment for CRPC, and a trend toward worse overall survival. CRPC developed in 41% within 1 year, with a median time to CRPC of 14.4 months. Treatment for CRPC was given in 84 cases, with 90% receiving either abiraterone or enzalutamide in the first-line, with a PSA decline ≥50% occurring in 47%. Conclusions:The effectiveness of docetaxel with ADT in a general population of patients with mCSPC was associated with poorer outcomes and high rates of toxicity compared to the published studies. Response rates to first-line treatment for mCRPC with abiraterone or enzalutamide appear similar to reported outcomes. K E Y W O R D S clinical effectiveness, docetaxel, prostate cancer The Prostate. 2019;79:281-287.wileyonlinelibrary.com/journal/pros

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“…While these data may suggest a potential preference for abiraterone-ADT over docetaxel-ADT for initial treatment, both therapies are feasible for newly diagnosed mHSPC. Data from two other similar studies17,18 suggest a relatively improved efficacy of abiraterone-ADT compared with docetaxel-ADT, again without significant differences in overall survival. For this reason, treatment choices continue to be driven by physician’s preference, convenience, and cost rather than relative efficacy 19–21.…”

Section: Introductionmentioning

confidence: 91%

Abiraterone acetate for early stage metastatic prostate cancer: patient selection and special considerations

Castellan¹,

Marchioni²,

Castellucci³

et al. 2018

TCRM

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In recent years, therapeutic advances, together with new medication sequences and combinations, have improved outcomes for prostate cancer. For a long time, androgen deprivation therapy (ADT) has been the standard of care for newly diagnosed, metastatic prostate cancer, first as a standalone therapy and then in combination with taxane-based regimens. More recently, the addition of abiraterone acetate to ADT to achieve complete androgen blockade has proven beneficial for the treatment of metastatic hormone-resistant prostate cancer and metastatic hormone-sensitive prostate cancer (mHSPC). In this review, we summarize recent findings on the early use of abiraterone in mHSPC and discuss survival benefits as reported in clinical trials. On the basis of existing data, abiraterone in combination with ADT could be considered a new standard of care for patients affected by mHSPC.

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What are the optimal systemic treatments for men with metastatic, hormone-sensitive prostate cancer? A STOPCaP systematic review and network meta-analysis

Cited by 7 publications

References 0 publications

Survival benefit, disease progression and quality-of-life outcomes of abiraterone acetate plus prednisone versus docetaxel in metastatic hormone-sensitive prostate cancer: A network meta-analysis

Survival benefit, disease progression and quality-of-life outcomes of abiraterone acetate plus prednisone versus docetaxel in metastatic hormone-sensitive prostate cancer: A network meta-analysis

Clinical effectiveness of docetaxel for castration‐sensitive prostate cancer in a real‐world population‐based analysis

Abiraterone acetate for early stage metastatic prostate cancer: patient selection and special considerations

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