Comparison of Systemic Treatments for Metastatic Castration-Sensitive Prostate Cancer: A Systematic Review and Network Meta-analysis

There are many treatments available for men presenting with newly-diagnosed metastatic prostate cancer, but it is unclear how they compare for their effectiveness, safety, and costs. Dr. Lin Wang and associates searched large databases in the published literature from randomized clinical trials through November 2019, to compare the effectiveness and safety of the many available treatments, including hormonal therapy and chemotherapy.

Seven trials including 7,287 patients comparing six treatments were identified. The results suggested that as treatments that could be added to standard hormonal therapy, abiraterone acetate (Zytiga®) and apalutamide (Erleada®) may provide the largest overall survival benefits with relatively low serious adverse side effects. Although enzalutamide (Xtandi®) -reduced disease progression to the greatest extent, it may be associated with more fatigue, and longer follow-up is needed to examine its overall survival benefits.

Wang, L et al JAMA Oncol PMID: 33443584