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. 2021 Jan:157:103198.
doi: 10.1016/j.critrevonc.2020.103198. Epub 2020 Dec 13.

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

Matteo Ferro  1 , Giuseppe Lucarelli  2 , Felice Crocetto  3 , Pasquale Dolce  4 , Antonio Verde  5 , Evelina La Civita  6 , Silvia Zappavigna  7 , Ottavio de Cobelli  1 , Giuseppe Di Lorenzo  8 , Bianca Arianna Facchini  7 , Luca Scafuri  5 , Livia Onofrio  5 , Angelo Porreca  9 , Gian Maria Busetto  10 , Guru Sonpavde  11 , Michele Caraglia  12 , Michele Klain  13 , Daniela Terracciano  6 , Sabino De Placido  14 , Carlo Buonerba  15
Affiliations

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

Matteo Ferro et al. Crit Rev Oncol Hematol. 2021 Jan.

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.

Keywords: Abiraterone; Apalutamide; Castration-sensitive prostate cancer; Enzalutamide.

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