Although both docetaxel and androgen-receptor-axis-targeted (ARAT) agents have yielded survival improvements in combination with androgen deprivation therapy (ADT) compared to ADT alone in metastatic castration-sensitive prostate cancer (mCSPC) patients, the optimal therapeutic choice remains to be established. We analyzed estimates of the hazard ratios for death (OS-HRs) in patients treated in the first-line setting enrolled in the GETUG-AFU15, CHAARTED, STAMPEDE, LATITUDE, ENZAMET, and TITAN trials. Overall, men with mCSPC receiving ADT with vs. without either an ARAT agent or docetaxel as first-line systemic therapy showed a pooled OS-HR of 0.69 (95 % CI: 0.61−0.78), with significant heterogeneity (p = 0.045, I2 = 52.5 %). Network meta-analysis showed an OS-HR in patients receiving an ARAT agent vs. docetaxel of 0.78 (95 %CI: 0.67−0.91). In conclusion, the evidence analysed indicates that an ARAT agent may provide improved OS outcomes compared to docetaxel. Prospective randomized trials are warranted.

First-line systemic therapy for metastatic castration-sensitive prostate cancer: An updated systematic review with novel findings / M. Ferro, G. Lucarelli, F. Crocetto, P. Dolce, A. Verde, E. La Civita, S. Zappavigna, O. de Cobelli, G. Di Lorenzo, B.A. Facchini, L. Scafuri, L. Onofrio, A. Porreca, G.M. Busetto, G. Sonpavde, M. Caraglia, M. Klain, D. Terracciano, S. De Placido, C. Buonerba. - In: CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY. - ISSN 1040-8428. - 157(2021 Jan). [10.1016/j.critrevonc.2020.103198]

First-line systemic therapy for metastatic castration-sensitive prostate cancer: An updated systematic review with novel findings

G. Lucarelli
Secondo
;
A. Verde;O. de Cobelli;G. Di Lorenzo;
2021

Abstract

Although both docetaxel and androgen-receptor-axis-targeted (ARAT) agents have yielded survival improvements in combination with androgen deprivation therapy (ADT) compared to ADT alone in metastatic castration-sensitive prostate cancer (mCSPC) patients, the optimal therapeutic choice remains to be established. We analyzed estimates of the hazard ratios for death (OS-HRs) in patients treated in the first-line setting enrolled in the GETUG-AFU15, CHAARTED, STAMPEDE, LATITUDE, ENZAMET, and TITAN trials. Overall, men with mCSPC receiving ADT with vs. without either an ARAT agent or docetaxel as first-line systemic therapy showed a pooled OS-HR of 0.69 (95 % CI: 0.61−0.78), with significant heterogeneity (p = 0.045, I2 = 52.5 %). Network meta-analysis showed an OS-HR in patients receiving an ARAT agent vs. docetaxel of 0.78 (95 %CI: 0.67−0.91). In conclusion, the evidence analysed indicates that an ARAT agent may provide improved OS outcomes compared to docetaxel. Prospective randomized trials are warranted.
Abiraterone; Apalutamide; Castration-sensitive prostate cancer; Enzalutamide; Androgen Antagonists; Castration; Docetaxel; Humans; Male; Prospective Studies; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant
Settore MED/24 - Urologia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/821302
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