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Updated: Nov 26, 2025
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
First-line systemic therapy for metastatic castration-sensitive prostate cancer: An updated systematic review with
Matteo Ferro1, Giuseppe Lucarelli2, Felice Crocetto3
1Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy.
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.
Insights
For metastatic castration-sensitive prostate cancer (mCSPC), androgen-receptor-axis-targeted (ARAT) agents combined with androgen deprivation therapy (ADT) may offer better survival than docetaxel plus ADT. Further trials are needed to confirm these findings.
Area of Science:
- Oncology
- Clinical Trials
- Prostate Cancer Research
Background:
- Metastatic castration-sensitive prostate cancer (mCSPC) treatment has advanced with docetaxel and androgen-receptor-axis-targeted (ARAT) agents added to androgen deprivation therapy (ADT).
- Optimal first-line therapy selection for mCSPC remains an area of active investigation.
Purpose of the Study:
- To compare the overall survival (OS) benefits of ARAT agents versus docetaxel when used with ADT in first-line mCSPC treatment.
- To analyze existing clinical trial data to inform therapeutic choices.
Main Methods:
- A meta-analysis of hazard ratios for death (OS-HRs) was performed using data from six major clinical trials (GETUG-AFU15, CHAARTED, STAMPEDE, LATITUDE, ENZAMET, TITAN).
- Network meta-analysis was employed to directly compare ARAT agents against docetaxel.
Main Results:
- The pooled analysis showed a significant OS benefit for ADT combined with either an ARAT agent or docetaxel (OS-HR = 0.69).
- Network meta-analysis indicated a superior OS outcome for ARAT agents compared to docetaxel (OS-HR = 0.78).
- Significant heterogeneity was observed in the pooled analysis.
Conclusions:
- Current evidence suggests that ARAT agents may offer improved overall survival compared to docetaxel in the first-line treatment of mCSPC when combined with ADT.
- Prospective randomized trials are recommended to definitively establish the superiority of ARAT agents.
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