First-line systemic therapy for metastatic castration-sensitive prostate cancer: An updated systematic review with novel findings

被引:38
作者
Ferro, Matteo [1 ]
Lucarelli, Giuseppe [2 ]
Crocetto, Felice [3 ]
Dolce, Pasquale [4 ]
Verde, Antonio [5 ]
Civita, Evelina La [6 ]
Zappavigna, Silvia [7 ]
Cobelli, Ottavio de [1 ]
Lorenzo, Giuseppe Di [8 ,9 ]
Facchini, Bianca Arianna [7 ]
Scafuri, Luca [5 ]
Onofrio, Livia [5 ]
Porreca, Angelo [10 ]
Busetto, Gian Maria [11 ]
Sonpavde, Guru [12 ]
Caraglia, Michele [7 ,13 ]
Klain, Michele [14 ]
Terracciano, Daniela [6 ]
Placido, Sabino De [5 ,15 ]
Buonerba, Carlo [15 ,16 ]
机构
[1] European Inst Oncol IRCCS, Div Urol, Milan, Italy
[2] Univ Bari, Dept Emergency & Organ Transplantat, Urol Androl & Kidney Transplantat Unit, Bari, Italy
[3] Univ Naples Federico II, Dept Neurosci Human Reprod & Odontostomatol, Naples, Italy
[4] Univ Naples Federico II, Dept Publ Hlth, Naples, Italy
[5] Univ Naples Federico II, Dept Clin Med & Surg, Naples, Italy
[6] Univ Naples Federico II, Dept Translat Med Sci, Naples, Italy
[7] Univ Campania L Vanvitelli, Dept Precis Med, Naples, Italy
[8] Hosp Andrea Tortora, Oncol Unit, ASL Salerno, Pagani, Italy
[9] Univ Molise, Dept Med & Hlth Sci Vincenzo Tiberio, Campobasso, Italy
[10] Abano Terme Hosp, Dept Urol, Padua, Italy
[11] Sapienza Univ Rome, Dept Urol, Rome, Italy
[12] Dana Farber Canc Inst, Genitourinary Oncol Sect, Boston, MA 02115 USA
[13] Biogem Scarl, Inst Genet Res, Lab Precis & Mol Oncol, Avellino, Italy
[14] Univ Naples Federico II, Dept Adv Biomed Sci, Naples, Italy
[15] AOU Federico II Naples, Dept Oncol & Hematol, Reg Reference Ctr Rare Tumors, Naples, Italy
[16] Ctr Referenza Nazl Anal & Studio Correlaz Ambient, Anim & Uomo, Ist Zooprofilatt Sperimentale Mezzogiorno, I-80055 Portici, Na, Italy
关键词
Castration-sensitive prostate cancer; Abiraterone; Enzalutamide; Apalutamide;
D O I
10.1016/j.critrevonc.2020.103198
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 castrationsensitive 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, I-2 = 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.
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页数:8
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