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

Matteo Ferro; Giuseppe Lucarelli; Felice Crocetto; Pasquale Dolce; Antonio Verde; Evelina La Civita; Silvia Zappavigna; Ottavio de Cobelli; Giuseppe Di Lorenzo; Bianca Arianna Facchini; Luca Scafuri; Livia Onofrio; Angelo Porreca; Gian Maria Busetto; Guru Sonpavde; Michele Caraglia; Michele Klain; Daniela Terracciano; Sabino De Placido; Carlo Buonerba

doi:10.1016/j.critrevonc.2020.103198

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

Crit Rev Oncol Hematol. 2021 Jan:157:103198. doi: 10.1016/j.critrevonc.2020.103198. Epub 2020 Dec 13.

Authors

Matteo Ferro¹, Giuseppe Lucarelli², Felice Crocetto³, Pasquale Dolce⁴, Antonio Verde⁵, Evelina La Civita⁶, Silvia Zappavigna⁷, Ottavio de Cobelli¹, Giuseppe Di Lorenzo⁸, Bianca Arianna Facchini⁷, Luca Scafuri⁵, Livia Onofrio⁵, Angelo Porreca⁹, Gian Maria Busetto¹⁰, Guru Sonpavde¹¹, Michele Caraglia¹², Michele Klain¹³, Daniela Terracciano⁶, Sabino De Placido¹⁴, Carlo Buonerba¹⁵

Affiliations

¹ Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy.
² Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy.
³ Department of Neurosciences, Human Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
⁴ Department of Public Health, Federico II University of Naples, Naples, Italy.
⁵ Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
⁶ Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
⁷ Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
⁸ Oncology Unit, Hospital "Andrea Tortora," ASL Salerno, Pagani, Italy; Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
⁹ Department of Urology, Abano Terme Hospital, Padua, Italy.
¹⁰ Department of Urology, Sapienza University of Rome, Roma, Italy.
¹¹ Genitourinary Oncology Section, Dana Farber Cancer Institute, Boston, MA, United States.
¹² Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy; Biogem Scarl, Institute of Genetic Research, Laboratory of Precision and Molecular Oncology, Ariano Irpino, Avellino, Italy.
¹³ Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
¹⁴ Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy; Regional Reference Center for Rare Tumors, Department of Oncology and Hematology, AOU Federico II of Naples, Naples, Italy.
¹⁵ Regional Reference Center for Rare Tumors, Department of Oncology and Hematology, AOU Federico II of Naples, Naples, Italy; Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, 80055, Portici (Na), Italy. Electronic address: carlo.buonerba@unina.it.

PMID: 33316417
DOI: 10.1016/j.critrevonc.2020.103198

Abstract

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 castration-sensitive 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, I² = 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.

Keywords: Abiraterone; Apalutamide; Castration-sensitive prostate cancer; Enzalutamide.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Androgen Antagonists
Castration
Docetaxel / therapeutic use
Humans
Male
Prospective Studies
Prostatic Neoplasms* / drug therapy
Prostatic Neoplasms, Castration-Resistant* / drug therapy

Substances

Androgen Antagonists
Docetaxel