PMID- 36730553
OWN - NLM
STAT- MEDLINE
DCOM- 20230209
LR  - 20230228
IS  - 1473-5741 (Electronic)
IS  - 0959-4973 (Linking)
VI  - 34
IP  - 3
DP  - 2023 Mar 1
TI  - A systematic review and meta-analysis on overall survival, failure-free survival 
      and safety outcomes in patients with metastatic hormone-sensitive prostate cancer 
      treated with new anti-androgens.
PG  - 405-412
LID - 10.1097/CAD.0000000000001419 [doi]
AB  - OBJECTIVE: Androgen-deprivation therapy (ADT) combined with new antiandrogens 
      have shown to improve the outcomes of patients with hormone-sensitive metastatic 
      prostate cancer. This systematic review and meta-analysis aim to compare the 
      efficacy and toxicity of these agents in this specific scenario. METHODS: 
      Randomized clinical trials (RCT) were identified after systematic searching of 
      databases. A random-effect model was used to determine the pooled hazard ratio 
      (HR) for overall survival (OS) and failure-free survival according to the 
      inverse-variance method. The Mantel-Haenszel method was used to calculate the 
      pooled odds ratio (OR) for treatment-related adverse events (AEs) grade 3 or 
      higher. Heterogeneity was determined using the Tau 2 and I2 statistics. RESULTS: 
      Seven trials were included in this meta-analysis ( n  = 7544). The addition of 
      ADT plus new-generation anti-androgens, specifically: abiraterone, apalutamide, 
      darolutamide or enzalutamide was associated with improved OS (pooled HR, 0.66; 
      95% CI, 0.61-0.71; P  < 0.00001) with no significant heterogeneity detected among 
      trials. (Tau 2  = 0; I2  = 0%; P  = 0.88). Failure-free survival was 
      significantly longer in the combination-therapy group than in the control group 
      (pooled HR, 0.43; 95% CI, 0.39-0.47; P  < 0.00001) This effect was consistent 
      among trials (Tau 2  = 0; I2  = 27%; P  = 0.22). The overall OR of AEs grade 3 or 
      higher was significantly increased with the use of the combination therapy 
      (pooled OR, 1.40; 95% CI, 1.13-1.74; P  = 0.002), with significant heterogeneity 
      among trials (Tau 2  = 0.07; I2  = 82%; P  < 0.0001). CONCLUSION: The addition of 
      either abiraterone, apalutamide, darolutamide or enzalutamide to ADT improves OS 
      and failure-free survival in hormone-sensitive metastatic prostate cancer, albeit 
      an increase in AEs.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Ramos-Esquivel, Allan
AU  - Ramos-Esquivel A
AD  - Departamento de Oncologia Medica, Hospital San Juan de Dios. Caja Costarricense 
      de Seguro Social, Universidad de Costa Rica, San Jose.
FAU - Garita-Rojas, Esteban
AU  - Garita-Rojas E
AD  - Escuela de Medicina. Universidad de Costa Rica, Costa Rica.
FAU - Masis-Marroquin, Adriana
AU  - Masis-Marroquin A
AD  - Escuela de Medicina. Universidad de Costa Rica, Costa Rica.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20221115
PL  - England
TA  - Anticancer Drugs
JT  - Anti-cancer drugs
JID - 9100823
RN  - 93T0T9GKNU (enzalutamide)
RN  - 0 (Androgen Antagonists)
RN  - 2010-15-3 (Phenylthiohydantoin)
RN  - 0 (Hormones)
SB  - IM
MH  - Male
MH  - Humans
MH  - *Prostatic Neoplasms/pathology
MH  - Androgen Antagonists/therapeutic use
MH  - Phenylthiohydantoin/therapeutic use
MH  - Hormones/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
EDAT- 2023/02/03 06:00
MHDA- 2023/02/10 06:00
CRDT- 2023/02/02 14:23
PHST- 2023/02/03 06:00 [pubmed]
PHST- 2023/02/10 06:00 [medline]
PHST- 2023/02/02 14:23 [entrez]
AID - 00001813-202303000-00008 [pii]
AID - 10.1097/CAD.0000000000001419 [doi]
PST - ppublish
SO  - Anticancer Drugs. 2023 Mar 1;34(3):405-412. doi: 10.1097/CAD.0000000000001419. 
      Epub 2022 Nov 15.