Systemic Therapy for Metastatic Hormone-Sensitive Prostate Cancer: A Randomized Controlled Trial-Based Network...

Area of Science:

• Oncology
• Pharmacology

Background:

• Metastatic hormone-sensitive prostate cancer (mHSPC) requires effective treatment strategies.
• Comparing various treatment regimens is crucial for optimizing patient outcomes.

Purpose of the Study:

• To conduct a network meta-analysis comparing different treatment strategies for mHSPC.
• To determine the most effective treatments for overall survival (OS) and failure-free survival (FFS).

Main Methods:

• Searched multiple databases for randomized controlled trials (RCTs) on mHSPC treatments.
• Extracted OS and FFS data from 18 RCTs involving 14,682 patients.
• Performed network meta-analysis and subgroup analyses based on patient characteristics.

Main Results:

• Androgen-deprivation therapy (ADT) + apalutamide (APA) showed the highest probability for improving OS (96.2%) and FFS (68.0%).
• Subgroup analyses identified ADT + enzalutamide (ENZA) and ADT + abiraterone acetate + prednisone (AAP) as leading treatments for OS in specific patient groups.
• Abiraterone, enzalutamide, and APA demonstrated significant efficacy, with APA showing the most prominent effects.

Conclusions:

• Endocrine therapies including abiraterone, enzalutamide, and APA are effective for mHSPC.
• ADT + APA is recommended as a primary treatment option for mHSPC patients, considering individual clinical conditions.