Cargando…
Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis
In recent years, significant changes have occurred in metastatic hormone-sensitive prostate cancer (mHSPC) management, where docetaxel and new androgen receptor pathway inhibitors (ARPI) have been shown to improve overall survival (OS) compared to androgen deprivation therapy (ADT). Recent data coul...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776703/ https://www.ncbi.nlm.nih.gov/pubmed/36547161 http://dx.doi.org/10.3390/curroncol29120747 |
_version_ | 1784855927512367104 |
---|---|
author | Fiorica, Francesco Buttigliero, Consuelo Grigolato, Daniela Muraro, Marco Turco, Fabio Munoz, Fernando Tucci, Marcello |
author_facet | Fiorica, Francesco Buttigliero, Consuelo Grigolato, Daniela Muraro, Marco Turco, Fabio Munoz, Fernando Tucci, Marcello |
author_sort | Fiorica, Francesco |
collection | PubMed |
description | In recent years, significant changes have occurred in metastatic hormone-sensitive prostate cancer (mHSPC) management, where docetaxel and new androgen receptor pathway inhibitors (ARPI) have been shown to improve overall survival (OS) compared to androgen deprivation therapy (ADT). Recent data could once again radically change mHSPC treatment. PEACE-1 and ARASENS trials demonstrated a survival benefit of the addition of ARPI to docetaxel and ADT combination (triplet therapy), compared to docetaxel and ADT. With multiple options to choose from, it is crucial to identify the patients who would benefit most from triplet therapy. In this meta-analysis, we evaluated the activity of the triplet therapy versus docetaxel plus ADT in mHSPC. A systematic review of PubMed/Medline, Embase, and the proceedings of major international meetings was performed. Five RCTs fulfilled the inclusion criteria. PEACE-1 and ARASENS studies reported disease-free survival (DFS) and OS. Post hoc analysis of three other trials evaluated the combination of ARPI, docetaxel and ADT. Globally, 2538 patients were included (1270 triplet therapy; 1268 docetaxel + ADT). Triplet therapy was associated with improved OS (hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.66–0.83, p < 0.00001). A statistically significant benefit was shown in high-volume mHSPC patients (HR 0.76; 95% CI 0.59–0.97, p = 0.03) and in patients with de novo metastatic disease (HR 0.73; 95% CI, 0.64–0.82, p < 0.00001). The addition of ARPI to standard therapy was associated with DFS improvement (HR 0.41; 95% CI, 0.35–0.49, p < 0.00001). This metanalysis shows a significant OS benefit from concomitant administration of ARPI, docetaxel and ADT in high volume and de novo mHSPC. |
format | Online Article Text |
id | pubmed-9776703 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97767032022-12-23 Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis Fiorica, Francesco Buttigliero, Consuelo Grigolato, Daniela Muraro, Marco Turco, Fabio Munoz, Fernando Tucci, Marcello Curr Oncol Systematic Review In recent years, significant changes have occurred in metastatic hormone-sensitive prostate cancer (mHSPC) management, where docetaxel and new androgen receptor pathway inhibitors (ARPI) have been shown to improve overall survival (OS) compared to androgen deprivation therapy (ADT). Recent data could once again radically change mHSPC treatment. PEACE-1 and ARASENS trials demonstrated a survival benefit of the addition of ARPI to docetaxel and ADT combination (triplet therapy), compared to docetaxel and ADT. With multiple options to choose from, it is crucial to identify the patients who would benefit most from triplet therapy. In this meta-analysis, we evaluated the activity of the triplet therapy versus docetaxel plus ADT in mHSPC. A systematic review of PubMed/Medline, Embase, and the proceedings of major international meetings was performed. Five RCTs fulfilled the inclusion criteria. PEACE-1 and ARASENS studies reported disease-free survival (DFS) and OS. Post hoc analysis of three other trials evaluated the combination of ARPI, docetaxel and ADT. Globally, 2538 patients were included (1270 triplet therapy; 1268 docetaxel + ADT). Triplet therapy was associated with improved OS (hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.66–0.83, p < 0.00001). A statistically significant benefit was shown in high-volume mHSPC patients (HR 0.76; 95% CI 0.59–0.97, p = 0.03) and in patients with de novo metastatic disease (HR 0.73; 95% CI, 0.64–0.82, p < 0.00001). The addition of ARPI to standard therapy was associated with DFS improvement (HR 0.41; 95% CI, 0.35–0.49, p < 0.00001). This metanalysis shows a significant OS benefit from concomitant administration of ARPI, docetaxel and ADT in high volume and de novo mHSPC. MDPI 2022-12-04 /pmc/articles/PMC9776703/ /pubmed/36547161 http://dx.doi.org/10.3390/curroncol29120747 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Fiorica, Francesco Buttigliero, Consuelo Grigolato, Daniela Muraro, Marco Turco, Fabio Munoz, Fernando Tucci, Marcello Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis |
title | Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis |
title_full | Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis |
title_fullStr | Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis |
title_full_unstemmed | Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis |
title_short | Addition of New Androgen Receptor Pathway Inhibitors to Docetaxel and Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Metanalysis |
title_sort | addition of new androgen receptor pathway inhibitors to docetaxel and androgen deprivation therapy in metastatic hormone-sensitive prostate cancer: a systematic review and metanalysis |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9776703/ https://www.ncbi.nlm.nih.gov/pubmed/36547161 http://dx.doi.org/10.3390/curroncol29120747 |
work_keys_str_mv | AT fioricafrancesco additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis AT buttiglieroconsuelo additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis AT grigolatodaniela additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis AT muraromarco additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis AT turcofabio additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis AT munozfernando additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis AT tuccimarcello additionofnewandrogenreceptorpathwayinhibitorstodocetaxelandandrogendeprivationtherapyinmetastatichormonesensitiveprostatecancerasystematicreviewandmetanalysis |