PMID- 31689828
OWN - NLM
STAT- MEDLINE
DCOM- 20191114
LR  - 20211204
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 98
IP  - 44
DP  - 2019 Nov
TI  - Efficacy and safety of abiraterone and enzalutamide for castration-resistant 
      prostate cancer: A systematic review and meta-analysis of randomized controlled 
      trials.
PG  - e17748
LID - 10.1097/MD.0000000000017748 [doi]
LID - e17748
AB  - BACKGROUND: Previous evidence directly evaluating the efficacy and safety of 
      abiraterone and enzalutamide treatment for castration-resistant prostate cancer 
      (CRPC) is limited. We aim to include more randomized controlled trials (RCTs) to 
      comprehensively assess the efficacy and safety of abiraterone and enzalutamide 
      treatment. METHODS: PubMed, Embase, and ClinicalTrial.gov were systematically 
      searched. Pooled hazard ratios (HRs) were calculated using Stata 12.0 software. 
      The comparison of the prostate-specific antigen (PSA) response rate and adverse 
      events (AEs) between the treatment and control groups were performed using RevMan 
      5.3 software. RESULTS: Eight eligible RCTs with 6,490 patients were selected. 
      Pooled HRs were 0.72 for overall survival, 0.45 for radiographic progression-free 
      survival (rPFS), and 0.36 for PSA PFS. abiraterone and enzalutamide could 
      significantly increase the PSA response rate OR = 8.67, 95%CI 4.42-17.04) and any 
      AE occurrence (OR = 1.98, 95%CI 1.46-2.68). The treatment group had more 
      occurrence of fatigue (OR = 1.34, 95%CI 1.20-1.49), back pain (OR = 1.15, 95%CI 
      1.01-1.15), hot flush (OR = 1.76, 95%CI 1.50-2.06), diarrhea (OR=1.22, 95%CI 
      1.07-2.40) and arthralgia (OR = 1.34, 95%CI 1.16-1.54). Particularly, AEs of 
      special interest including any grade hypertension (OR = 2.06, 95%CI 1.71-2.47), 
      hypokalemia (OR = 1.80, 95%CI 1.42-2.30) and fluid retention or edema (OR = 1.38, 
      95%CI 1.17-1.63) also occurred less in the control group. Moreover, a higher 
      incidence of high-grade hypertension (OR = 2.60, 95%CI 1.79-3.79) and extremity 
      pain (OR = 4.46, 95%CI 2.81-7.07) was observed in the treatment group. 
      CONCLUSION: The survival benefits of abiraterone and enzalutamide for CRPC were 
      evident and promising, while the risk of AE occurrence was also acceptably higher 
      in the treatment group than in the placebo group.
FAU - Zheng, Xiaonan
AU  - Zheng X
AD  - Department of Urology, Institute of Urology, Sichuan University, West China 
      Hospital, Chengdu.
FAU - Zhao, Xiaohui
AU  - Zhao X
AD  - West China Medical School, Sichuan University.
FAU - Xu, Hang
AU  - Xu H
AD  - West China Medical School, Sichuan University.
FAU - Han, Xin
AU  - Han X
AD  - West China Medical School, Sichuan University.
FAU - Xu, He
AU  - Xu H
AD  - Department of Urology, Institute of Urology, Sichuan University, West China 
      Hospital, Chengdu.
AD  - Department of Urology, the Third People's Hospital of Chengdu/The Affiliated 
      Hospital of Southwest Jiaotong University, Chengdu, Sichuan, PR China.
FAU - Dong, Xin
AU  - Dong X
AD  - West China Medical School, Sichuan University.
FAU - Peng, Ruilin
AU  - Peng R
AD  - West China Medical School, Sichuan University.
FAU - Yang, Lu
AU  - Yang L
AD  - Department of Urology, Institute of Urology, Sichuan University, West China 
      Hospital, Chengdu.
FAU - Wei, Qiang
AU  - Wei Q
AD  - Department of Urology, Institute of Urology, Sichuan University, West China 
      Hospital, Chengdu.
FAU - Ai, Jianzhong
AU  - Ai J
AD  - Department of Urology, Institute of Urology, Sichuan University, West China 
      Hospital, Chengdu.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Androstenes)
RN  - 0 (Benzamides)
RN  - 0 (Nitriles)
RN  - 2010-15-3 (Phenylthiohydantoin)
RN  - 93T0T9GKNU (enzalutamide)
RN  - G819A456D0 (abiraterone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Androstenes/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Benzamides
MH  - Disease-Free Survival
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nitriles
MH  - Phenylthiohydantoin/*analogs & derivatives/therapeutic use
MH  - Progression-Free Survival
MH  - Proportional Hazards Models
MH  - Prostatic Neoplasms, Castration-Resistant/*drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
PMC - PMC6946394
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2019/11/07 06:00
MHDA- 2019/11/15 06:00
PMCR- 2019/11/01
CRDT- 2019/11/07 06:00
PHST- 2019/11/07 06:00 [entrez]
PHST- 2019/11/07 06:00 [pubmed]
PHST- 2019/11/15 06:00 [medline]
PHST- 2019/11/01 00:00 [pmc-release]
AID - 00005792-201911010-00088 [pii]
AID - MD-D-19-05577 [pii]
AID - 10.1097/MD.0000000000017748 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2019 Nov;98(44):e17748. doi: 10.1097/MD.0000000000017748.