Evidence map›Paper›PMID 38750344›Full record

SynthesisClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2024

Comparative effectiveness of first-line systemic treatments for metastatic castration-resistant prostate cancer: a systematic review and network meta-analysis.

Jiahuan Ai, Liuying Jian, Xiaoqin Wen, Xiaotong Huo, Xuanyi Yang, Jie Jiang, Tiantian Zhang

Abstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jiahuan Ai *College of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China.ORCID http://orcid.org/0009-0006-5349-0869
Liuying Jian *College of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China.
Xiaoqin WenCollege of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China.
Xiaotong HuoCollege of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China.
Xuanyi YangCollege of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China.
Jie JiangCollege of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China. jiangjie218@126.com.
Tiantian ZhangCollege of Pharmacy/Southern Institute of Pharmacoeconomics and Health Technology Assessment, Jinan University, Guangzhou, 510632, China. ztt_84@126.com.

Funding

National Natural Science Foundation of China 72274079
6 · The paper itself

Abstract

objectivesNo head-to-head trials had been performed to estimate the relative effectiveness of poly ADP-ribose polymerase inhibitor (PARPi) and androgen receptor signaling inhibitor (ARSi) in the first-line treatment for metastatic castration-resistant prostate cancer (mCRPC). We aimed to perform a systematic review and network meta-analysis to evaluate the comparative effectiveness of various systemic treatment agents for patients with mCRPC.

methodsA comprehensive literature search was conducted for abstracts and full-text articles from the database's inception through April 27, 2023. The study concentrated on assessing radiographic progression-free survival (rPFS) for both overall and homologous recombination repair mutation (HRRm) population, with overall survival (OS) as the secondary measure. Under the Bayesian framework, the overall effect was pooled using the fixed-effects model in base case analysis. Scenario analysis using restricted mean survival time (RMST) methods was performed to test the robustness of the results.

resultsNine studies with 6,830 patients and 8 unique treatment options were included. Network meta-analysis demonstrated that talazoparib in combination with enzalutamide (TALA + ENZA; overall population, hazard ratio [HR], 0.20; 95% credible interval [CrI]: 0.16-0.26; RMST, 3.51; 95% confidence interval [CI] 2.46-4.60; HRRm population, HR, 0.15; 95% CrI: 0.09-0.23; RMST, 4.14; 95% CI 2.84-5.39) was superior to other treatments in the first-line setting in terms of rPFS. The results of Bayesian framework and RMST models showed consistent efficacy ranks. When extrapolated to overall survival benefit, within the Bayesian framework, olaparib plus abiraterone acetate and prednisone (OLAP + AAP) achieved the highest OS benefit for the overall population, which was not statistically significant when compared to TALA + ENZA. However, TALA + ENZA achieved the highest OS benefit at 3 years by applying RMST.

conclusionsWe suggest that talazoparib in combination with enzalutamide is probably a preferred treatment agent for the overall population and HRRm patients with mCRPC. Given the limitations of network framework and the modeling assumptions undertaken to finalize the analyses, results should be cautiously interpreted.

Indexed as

Androgen Receptor AntagonistsAntineoplastic Combined Chemotherapy ProtocolsPoly(ADP-ribose) Polymerase InhibitorsProstatic Neoplasms, Castration-ResistantAbiraterone AcetateBayes TheoremBenzamidesHumansMaleNitrilesPhenylthiohydantoinPhthalazinesPiperazinesProgression-Free SurvivalAbiraterone AcetateAndrogen Receptor AntagonistsBenzamidesenzalutamideNitrilesolaparibPhenylthiohydantoinPhthalazinesPiperazinesPoly(ADP-ribose) Polymerase InhibitorstalazoparibAndrogen receptor signaling inhibitorEffectivenessFirst-line treatmentMetastatic castration-resistant prostate cancerNetwork meta-analysisPARP inhibitor

Identifiers

PMID38750344

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.