PMID- 32605736
OWN - NLM
STAT- MEDLINE
DCOM- 20210812
LR  - 20210812
IS  - 1873-2496 (Electronic)
IS  - 1078-1439 (Linking)
VI  - 38
IP  - 11
DP  - 2020 Nov
TI  - Comparative efficacy of apalutamide darolutamide and enzalutamide for treatment 
      of non-metastatic castrate-resistant prostate cancer: A systematic review and 
      network meta-analysis.
PG  - 826-834
LID - S1078-1439(20)30128-9 [pii]
LID - 10.1016/j.urolonc.2020.03.022 [doi]
AB  - INTRODUCTION: Studies using apalutamide, enzalutamide, or darolutamide have shown 
      improved metastasis free survival (MFS) rates, leaving clinicians with a dilemma 
      of choosing one over the other, for nonmetastatic castration recurrent prostate 
      cancer (nmCRPC). We performed a network meta-analysis to provide an indirect 
      comparison of oncologic outcomes and adverse events (AEs) of these medications. 
      MATERIAL AND METHODS: We searched PubMed, MEDLINE, and SCOPUS databases, for 
      studies reporting apalutamide, enzalutamide, or darolutamide until January 25, 
      2020. Results were input into an EndNote library, and data were extracted into a 
      predefined template. Progression free survival (PFS) was defined as radiologic 
      progression or death. Network meta-analysis was done using R and meta-analysis 
      was performed with RevMan v. 5. Surface under the cumulative ranking (SUCRA) 
      value was used to provide rank probabilities. RESULTS: We found 3 studies 
      reporting results for apalutamide, enzalutamide, and darolutamide. MFS was 
      significantly lower in patients receiving darolutamide compared to both 
      apalutamide (hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.55-0.97) 
      and enzalutamide (HR: 0.71, 95% CI: 0.54-0.93). MFS was similar for enzalutamide 
      and apalutamide (HR: 0.97, 95% CI: 0.73-1.28). In PFS, apalutamide showed a 
      slightly higher rate compared to darolutamide (HR: 0.76, 95% CI: 0.59-0.99). 
      There was no difference in overall survival (OS) between any of the medications. 
      There was no statistically significant difference in AEs profile of the 3 
      medications. However, darolutamide had the highest SUCRA value and probability of 
      being the most preferred medication based on AEs profile. CONCLUSION: 
      Enzalutamide and apalutamide had similar and higher MFS rate in indirect 
      comparison with darolutamide. In cases where AEs are concerning, darolutamide 
      might be the preferred agent.
CI  - Copyright (c) 2020. Published by Elsevier Inc.
FAU - Kumar, Jatinder
AU  - Kumar J
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Jazayeri, Seyed Behzad
AU  - Jazayeri SB
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Gautam, Shiva
AU  - Gautam S
AD  - Department of Biostatistics, University of Florida, Jacksonville, FL.
FAU - Norez, Daniel
AU  - Norez D
AD  - Department of Biostatistics, University of Florida, Jacksonville, FL.
FAU - Alam, Muhammad Umar
AU  - Alam MU
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Tanneru, Karthik
AU  - Tanneru K
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Bazargani, Soroush
AU  - Bazargani S
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Costa, Joseph
AU  - Costa J
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Bandyk, Mark
AU  - Bandyk M
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Ganapathi, Hariharan Palayapalayam
AU  - Ganapathi HP
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Koochekpour, Shahriar
AU  - Koochekpour S
AD  - Department of Urology, University of Florida, Jacksonville, FL.
FAU - Balaji, K C
AU  - Balaji KC
AD  - Department of Urology, University of Florida, Jacksonville, FL. Electronic 
      address: kc.balaji@jax.ufl.edu.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200628
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
RN  - 0 (Benzamides)
RN  - 0 (Nitriles)
RN  - 0 (Pyrazoles)
RN  - 0 (Thiohydantoins)
RN  - 0 (apalutamide)
RN  - 0 (darolutamide)
RN  - 2010-15-3 (Phenylthiohydantoin)
RN  - 93T0T9GKNU (enzalutamide)
SB  - IM
MH  - Benzamides/*therapeutic use
MH  - Humans
MH  - Male
MH  - Network Meta-Analysis
MH  - Nitriles/*therapeutic use
MH  - Phenylthiohydantoin/*therapeutic use
MH  - Prostatic Neoplasms, Castration-Resistant/*drug therapy
MH  - Pyrazoles/*therapeutic use
MH  - Thiohydantoins/*therapeutic use
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Apalutamide
OT  - Castration resistance prostate cancer
OT  - Darolutamide
OT  - Enzalutamide
OT  - Network meta analyses
EDAT- 2020/07/02 06:00
MHDA- 2021/08/13 06:00
CRDT- 2020/07/02 06:00
PHST- 2020/02/06 00:00 [received]
PHST- 2020/03/12 00:00 [revised]
PHST- 2020/03/21 00:00 [accepted]
PHST- 2020/07/02 06:00 [pubmed]
PHST- 2021/08/13 06:00 [medline]
PHST- 2020/07/02 06:00 [entrez]
AID - S1078-1439(20)30128-9 [pii]
AID - 10.1016/j.urolonc.2020.03.022 [doi]
PST - ppublish
SO  - Urol Oncol. 2020 Nov;38(11):826-834. doi: 10.1016/j.urolonc.2020.03.022. Epub 
      2020 Jun 28.