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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Oncotarget
2017 ; 8
(35
): 59690-59697
Nephropedia Template TP
gab.com Text
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English Wikipedia
Comparing the clinical efficacy of abiraterone acetate, enzalutamide, and
orteronel in patients with metastatic castration-resistant prostate cancer by
performing a network meta-analysis of eight randomized controlled trials
#MMPMID28938672
Kang M
; Jeong CW
; Kwak C
; Ku JH
; Kim HH
Oncotarget
2017[Aug]; 8
(35
): 59690-59697
PMID28938672
show ga
Various novel androgen receptor (AR) targeting drugs have been developed recently
and have shown beneficial effects on survival in patients with metastatic
castration-resistant prostate cancer (mCRPC). However, no consensus has been
reached regarding which of these agents provides the most favorable oncological
outcomes. Here, we aimed to compare the efficacy of novel AR-targeted agents by
performing a network meta-analysis of randomized controlled trials (RCTs). We
included eight RCTs for men with mCRPC treated with one of the AR targeting
agents: abiraterone acetate, enzalutamide, or orteronel. The primary endpoint was
overall survival (OS), while the secondary endpoints were progression-free
survival (PFS), prostate-specific antigen (PSA) responsiveness, time to PSA
progression, time to first skeletal-related events (SRE), and adverse events
(AEs). Pairwise meta-analysis and network meta-analysis were conducted to obtain
direct and indirect evidence, respectively. Notably, enzalutamide and abiraterone
were significantly associated with improved OS compared with control arms.
Enzalutamide was ranked as the most efficacious agent for improving OS (hazard
ratio [HR] = 0.71), and abiraterone appeared to be the second-most efficacious
drug for this purpose (HR = 0.78). Enzalutamide improved PFS in comparison with
control groups (HR = 0.36), but abiraterone and orteronel were not significantly
associated with PFS improvements. Enzalutamide (HR = 0.20) and abiraterone (HR =
0.56) were significantly associated with prolonged times to PSA progression as
compared with control groups. However, only orteronel was associated with an
increased risk of AEs as compared with control groups. In summary, our study can
help to guide treatment selection, especially because AR-targeted agents have not
been compared directly in head-to-head trials.