Evidence map›Paper›PMID 40493311›Full record

ArticleTargeted oncology2025

A Bayesian Network Meta-analysis of Systemic Treatments for Metastatic Castration-Resistant Prostate Cancer in First- and Subsequent Lines.

Marie Wosny, Stefanie Aeppli, Stefanie Fischer, Tobias Peres, Christian Rothermundt, Janna Hastings

Abstract readNetwork Meta-Analysis
In one paragraph

Article in Targeted oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

6 authors.

Marie WosnySchool of Medicine, University of St. Gallen (HSG), St. Jakob-Strasse 21, 9000, St. Gallen, Switzerland. mariejohanna.wosny@unisg.ch.ORCID http://orcid.org/0009-0000-2791-0774
Stefanie AeppliDepartment of Medical Oncology and Hematology, HOCH Health Ostschweiz, Kantonsspital St. Gallen (KSSG), St. Gallen, Switzerland.ORCID http://orcid.org/0000-0003-2779-5942
Stefanie FischerDepartment of Medical Oncology and Hematology, HOCH Health Ostschweiz, Kantonsspital St. Gallen (KSSG), St. Gallen, Switzerland.ORCID http://orcid.org/0000-0001-9609-3640
Tobias PeresDepartment of Medical Oncology and Hematology, HOCH Health Ostschweiz, Kantonsspital St. Gallen (KSSG), St. Gallen, Switzerland.ORCID http://orcid.org/0009-0005-8894-6961
Christian RothermundtDepartment of Medical Oncology and Cancer Center, Luzerner Kantonsspital (LUKS), Lucerne, Switzerland.ORCID http://orcid.org/0000-0002-2104-7794
Janna HastingsSchool of Medicine, University of St. Gallen (HSG), St. Jakob-Strasse 21, 9000, St. Gallen, Switzerland.ORCID http://orcid.org/0000-0002-3469-4923

Funding

Universität St. Gallen This study was funded by the School of Medicine at the University of St. Gallen in Switzerland under grant number 2300380.
6 · The paper itself

Abstract

backgroundMetastatic castration-resistant prostate cancer (mCRPC) presents a challenge for clinicians in determining the optimal treatment sequence because of the lack of direct head-to-head comparisons, which is further complicated by the now-widespread use of androgen receptor pathway inhibitors (ARPIs) in metastatic hormone-sensitive prostate cancer (mHSPC).

objectiveThis study is a Bayesian network meta-analysis (NMA) intended to provide a comprehensive evaluation and comparison of the efficacy of mCRPC treatments across different treatment lines. PATIENTS AND

methodsWe performed a systematic search of ClinicalTrials.gov, extracted information, assessed the risk of bias, and reconstructed missing outcomes. We performed an NMA to evaluate treatment efficacy for overall survival (OS) and progression-free survival (PFS) in first and subsequent lines. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) NMA guidelines and was registered with PROSPERO (CRD42024499607).

resultsThe NMA included 43 trials with 33,494 patients. ARPI-based therapies, particularly in combination with poly(ADP-ribose) polymerase inhibitors, demonstrated the most significant benefits for OS and PFS in first-line mCRPC treatment, followed by chemotherapy regimens. However, ARPI re-treatment showed limited effectiveness in subsequent lines, leading to weaker OS and PFS benefits.

conclusionsThis NMA highlights the superiority of ARPI-based therapies and chemotherapies as first-line options for mCRPC while emphasizing the need for treatment class switching after ARPI failure. To refine treatment sequencing and enable precision care, future research should integrate individual participant data to better address patient-level heterogeneity and identify biomarkers for personalized therapy.

Indexed as

Prostatic Neoplasms, Castration-ResistantBayes TheoremClinical Trials as TopicHumansMaleNeoplasm Metastasis

Identifiers

PMID40493311
PMCPMC12307537

What Socratic holds

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LicenceCC BY-NC
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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.