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Updated: Jan 8, 2026
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Impact of Metastatic Hormone-sensitive Prostate Cancer Treatments on Health-related Quality of Life: A Systematic
Tessa van Elst1, Pedro Lopez2, Laurien M Buffart3
1Department of Urology, Santeon Hospital Group, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands; Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands.
Background And Objective:
In metastatic hormone-sensitive prostate cancer (mHSPC), health-related quality of life (HRQoL) is key for personalised treatment decisions. We compared the impact of different mHSPC treatment strategies on HRQoL, tackling a previously unaddressed challenge in comparing the outcomes across different patient-reported outcome measures (PROMs).
Methods:
A systematic review was conducted of prospective studies reporting HRQoL outcomes of androgen deprivation therapy (ADT) alone or with placebo, radiotherapy, abiraterone, apalutamide, enzalutamide, and/or docetaxel in mHSPC (CRD42021227902). Databases were searched in April 2022 and April 2024. HRQoL domains across different PROMs were harmonised using the Wilson and Cleary model. A frequentist network meta-analysis (NMA) compared 12-mo treatment effects using standardised mean differences (SMDs) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05.
Key Findings And Limitations:
Of the 24 articles included, nine were analysed in the NMA (eight trials, n = 6248). ADT + abiraterone resulted in significantly less pain than ADT + placebo (SMD: -0.22, 95% CI [-0.33; -0.10], p < 0.001), ADT + apalutamide (SMD: -0.17, 95% CI [-0.31; -0.02], p = 0.022), and ADT + enzalutamide (SMD: -0.23, 95% CI [-0.37; -0.09], p = 0.001). Less fatigue was observed with ADT + abiraterone versus ADT + enzalutamide (SMD: -0.45, 95% CI [-0.88; -0.02], p = 0.041). ADT + abiraterone showed significantly better physical functioning than ADT + enzalutamide (p = 0.015) and ADT + placebo (p = 0.032). Both were also associated with significantly worse general health perception than ADT alone, ADT + docetaxel, and ADT + radiotherapy. General health perception and overall quality of life were significantly better with ADT + abiraterone than with ADT + enzalutamide, ADT + apalutamide, and ADT + placebo (p < 0.001). The limitations include heterogeneity (0-76%) and few eligible trials.
Conclusions And Clinical Implications:
HRQoL outcomes differ across treatment strategies for mHSPC. At 12 mo, ADT + abiraterone yielded the most favourable HRQoL profile.
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