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...

Descripción completa

Detalles Bibliográficos
Autores principales: Fiorica, Francesco, Buttigliero, Consuelo, Grigolato, Daniela, Muraro, Marco, Turco, Fabio, Munoz, Fernando, Tucci, Marcello
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