What kind of patients with castration-naïve prostate cancer can benefit from upfront docetaxel and abiraterone: A systematic review and a network meta-analysis

Sun, Guangxi; Zhang, Xingming; Chen, Junru; Liao, Banghua; Liu, Zhenhua; Zhao, Jinge; Gao, Allen C.; Yang, Yaojing; Shu, Kunpeng; Liu, Jiandong; Zhao, Peng; Shen, Pengfei; Zeng, Hao

doi:10.1016/j.urolonc.2018.09.005

Cited by 15 publications

(63 citation statements)

References 26 publications

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“…Our results were in consistence with previous studies which reported the superiority of docetaxel and abiraterone to standard ADT in patients with mHSPC (16,17,24,25). However, whether abiraterone is better than docetaxel in this population remains a debate.…”

Section: Discussionsupporting

confidence: 91%

“…Several previous meta-analyses have indirectly compared various systemic therapies in terms of survival benefit in mHSPC patients ( 16 , 17 , 24 ). Recently, ADT in combination with novel AR-targeted therapies including enzalutamide and apalutamide has been reported to improve survival in patients with mHSPC, which provided extra effective systemic treatment choices for this population.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Current Systemic Combination Therapies for Metastatic Hormone-Sensitive Prostate Cancer and Selection of Candidates for Optimal Treatment: A Systematic Review and Bayesian Network Meta-Analysis

Chen

Sun

et al. 2020

Front. Oncol.

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Objective: To compare the efficacy and safety of current systemic combination therapies for patients with mHSPC and help select candidates for optimal treatment. Methods: Databases of MEDLINE and EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trial.gov were searched for eligible studies. Direct and network meta-analysis were conducted to compare various systemic combination therapies and the surface under the cumulative ranking curve (SUCRA) was generated for treatment ranking. Subgroup analyses were performed according to the extent of metastasis. Adverse events (AEs) were compared among the effective treatments. Results: Ten trials with 16 publications were included in this network meta-analysis. Direct and network meta-analysis consistently suggested that androgen-deprivation therapy (ADT) combined with docetaxel, abiraterone, enzalutamide, or apalutamide could significantly improve overall survival (OS) and failure-free survival (FFS) compared to ADT alone in men with mHSPC. SUCRA analysis demonstrated the superiority of ADT plus abiraterone or enzalutamide over other therapies. Subgroup analyses indicated that additional abiraterone to ADT had the highest ranking in patients with high-volume diseases or visceral metastases and enzalutamide plus ADT outperformed other treatments in patients with low-volume diseases or without visceral metastases. Different combination therapies had variable AE profiles and ADT in addition with docetaxel or abiraterone had the highest risk of AEs. Conclusion: ADT plus docetaxel, abiraterone, enzalutamide, or apalutamide were associated with significantly improved survival in patients with mHSPC. ADT plus abiraterone or enzalutamide appeared to be the most effective treatments. Clinicians should balance the efficacy, potential AEs, and disease status to select the optimal treatment.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Comparison of Current Systemic Combination Therapies for Metastatic Hormone-Sensitive Prostate Cancer and Selection of Candidates for Optimal Treatment: A Systematic Review and Bayesian Network Meta-Analysis

Chen

Sun

et al. 2020

Front. Oncol.

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“…Finally, the latest research proved that ADT plus ABI or DOC treatment is a better therapeutic strategy than ADT alone for metastatic hormone-sensitive PCa patients. 31,32 Yet, because patients included in this study were diagnosed with PCa in a relatively early era, none of them received the upfront treatment of either ABI or DOC, which might potentially limit the clinical impact of our findings.…”

Section: Psa-pfs Rpfsmentioning

confidence: 99%

AKR1C3 expression in primary lesion rebiopsy at the time of metastatic castration‐resistant prostate cancer is strongly associated with poor efficacy of abiraterone as a first‐line therapy

et al. 2019

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Background Previous studies had demonstrated that aldo‐keto reductase family 1 member C3 (AKR1C3), a crucial enzyme in the steroidogenic pathway, played an important role in abiraterone (ABI)‐resistance in metastatic castration‐resistant prostate cancer (mCRPC) by increasing intratumoral androgen synthesis. However, its value in predicting treatment response in patients with mCRPC is unknown. Method and Materials Data of 163 patients with metastatic prostate cancer between 2016 and 2018 were retrospectively analyzed. All patients received androgen deprivation therapy plus bicalutamide after initial diagnosis. After mCRPC, either ABI or docetaxel (DOC) treatment was used. No patient had the experience of therapy to the primary tumor. AKR1C3 protein was detected by immunohistochemical staining from rebiopsy (re‐Bx) of primary prostate lesions at mCRPC. Kaplan‐Meier curves and Cox regression were used to analyze the association between AKR1C3 and treatment outcomes. Results AKR1C3 was positive in 58 of 163 (35.6%) cases. AKR1C3 was associated with significantly shorter median prostate‐specific antigen progression‐free survival (mPSA‐PFS, 5.6 mo vs 10.7 mo; P < .001), median radiographic progression‐free survival (mrPFS, 11.1 mo vs 18.0 mo; P = .018), and numerically shorter median overall survival (mOS, 20.4 mo vs 26.4 mo; P = .157). Notably, AKR1C3‐positive patients treated with ABI, but not DOC, had shorter mPSA‐PFS and mrPFS compared with AKR1C3‐negative men, (mPSA‐PFS, 5.7 mo vs. 11.2 mo; P < .001; mrPFS, 12.4 mo vs 23.3 mo; P = .048). However, AKR1C3 expression had no correlation to PSA response or OS. Multivariate Cox regression indicated that AKR1C3 was independently accompanied with rapid PSA progression (hazard ratio [HR], 3.64; 95% confidence interval [CI], 2.10‐6.31; P < 0.001) and radiological progression (HR, 2.08; 95% CI, 1.05‐4.11; P = .036) in the ABI‐treated subgroup. Conclusion This study demonstrated that AKR1C3 detection in tissues from prostate re‐Bx at mCRPC was associated with early resistance to ABI but not DOC. These results will help to make optimal personalized treatment decisions for patients with mCRPC, facilitate physicians predicting the effectiveness of ABI.

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“…We identi ed nineteen eligible articles, published between August 2017 and December 2019, describing thirteen individual reviews. Ten reviews [16][17][18][19][20][21][22][23][24][25] appeared as peer-reviewed articles, of which ve also appeared in the form of one or more conference abstracts [26][27][28][29][30][31]; a further three reviews [32][33][34] were described in conference proceedings only. A ow diagram is shown in Additional le 2, and eligible reviews are summarised in Additional le 3.…”

Section: Resultsmentioning

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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What kind of patients with castration-naïve prostate cancer can benefit from upfront docetaxel and abiraterone: A systematic review and a network meta-analysis

Cited by 15 publications

References 26 publications

Comparison of Current Systemic Combination Therapies for Metastatic Hormone-Sensitive Prostate Cancer and Selection of Candidates for Optimal Treatment: A Systematic Review and Bayesian Network Meta-Analysis

Comparison of Current Systemic Combination Therapies for Metastatic Hormone-Sensitive Prostate Cancer and Selection of Candidates for Optimal Treatment: A Systematic Review and Bayesian Network Meta-Analysis

AKR1C3 expression in primary lesion rebiopsy at the time of metastatic castration‐resistant prostate cancer is strongly associated with poor efficacy of abiraterone as a first‐line therapy

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

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