PMID- 28938672
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20170925
LR  - 20231112
IS  - 1949-2553 (Electronic)
IS  - 1949-2553 (Linking)
VI  - 8
IP  - 35
DP  - 2017 Aug 29
TI  - Comparing the clinical efficacy of abiraterone acetate, enzalutamide, and 
      orteronel in patients with metastatic castration-resistant prostate cancer by 
      performing a network meta-analysis of eight randomized controlled trials.
PG  - 59690-59697
LID - 10.18632/oncotarget.17741 [doi]
AB  - Various novel androgen receptor (AR) targeting drugs have been developed recently 
      and have shown beneficial effects on survival in patients with metastatic 
      castration-resistant prostate cancer (mCRPC). However, no consensus has been 
      reached regarding which of these agents provides the most favorable oncological 
      outcomes. Here, we aimed to compare the efficacy of novel AR-targeted agents by 
      performing a network meta-analysis of randomized controlled trials (RCTs). We 
      included eight RCTs for men with mCRPC treated with one of the AR targeting 
      agents: abiraterone acetate, enzalutamide, or orteronel. The primary endpoint was 
      overall survival (OS), while the secondary endpoints were progression-free 
      survival (PFS), prostate-specific antigen (PSA) responsiveness, time to PSA 
      progression, time to first skeletal-related events (SRE), and adverse events 
      (AEs). Pairwise meta-analysis and network meta-analysis were conducted to obtain 
      direct and indirect evidence, respectively. Notably, enzalutamide and abiraterone 
      were significantly associated with improved OS compared with control arms. 
      Enzalutamide was ranked as the most efficacious agent for improving OS (hazard 
      ratio [HR] = 0.71), and abiraterone appeared to be the second-most efficacious 
      drug for this purpose (HR = 0.78). Enzalutamide improved PFS in comparison with 
      control groups (HR = 0.36), but abiraterone and orteronel were not significantly 
      associated with PFS improvements. Enzalutamide (HR = 0.20) and abiraterone (HR = 
      0.56) were significantly associated with prolonged times to PSA progression as 
      compared with control groups. However, only orteronel was associated with an 
      increased risk of AEs as compared with control groups. In summary, our study can 
      help to guide treatment selection, especially because AR-targeted agents have not 
      been compared directly in head-to-head trials.
FAU - Kang, Minyong
AU  - Kang M
AD  - Department of Urology, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Jeong, Chang Wook
AU  - Jeong CW
AD  - Department of Urology, Seoul National University Hospital, Seoul, Republic of 
      Korea.
FAU - Kwak, Cheol
AU  - Kwak C
AD  - Department of Urology, Seoul National University Hospital, Seoul, Republic of 
      Korea.
FAU - Ku, Ja Hyeon
AU  - Ku JH
AD  - Department of Urology, Seoul National University Hospital, Seoul, Republic of 
      Korea.
FAU - Kim, Hyeon Hoe
AU  - Kim HH
AD  - Department of Urology, Seoul National University Hospital, Seoul, Republic of 
      Korea.
LA  - eng
PT  - Journal Article
DEP - 20170510
PL  - United States
TA  - Oncotarget
JT  - Oncotarget
JID - 101532965
PMC - PMC5601768
OTO - NOTNLM
OT  - androgen receptor signaling
OT  - castration-resistant prostate cancer
OT  - network meta-analysis
OT  - systematic review
OT  - targeted drug
COIS- CONFLICTS OF INTEREST None declared.
EDAT- 2017/09/25 06:00
MHDA- 2017/09/25 06:01
PMCR- 2017/08/29
CRDT- 2017/09/24 06:00
PHST- 2017/02/27 00:00 [received]
PHST- 2017/04/25 00:00 [accepted]
PHST- 2017/09/24 06:00 [entrez]
PHST- 2017/09/25 06:00 [pubmed]
PHST- 2017/09/25 06:01 [medline]
PHST- 2017/08/29 00:00 [pmc-release]
AID - 17741 [pii]
AID - 10.18632/oncotarget.17741 [doi]
PST - epublish
SO  - Oncotarget. 2017 May 10;8(35):59690-59697. doi: 10.18632/oncotarget.17741. 
      eCollection 2017 Aug 29.