Evidence map›Paper›PMID 41366131›Full record

ArticleProstate cancer and prostatic diseases2026

Efficacy and safety of treatments for metastatic castration-sensitive prostate cancer: A comprehensive network meta-analysis including final ARANOTE data.

Neal Shore, Alicia K Morgans, Noman Paracha, Elaine Gallagher, Howard Thom, David Aceituno, Philip Orishaba, Stephen Stefani, Quoc-Dien Trinh, Christopher J D Wallis and 2 more

Abstract readNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Article in Prostate cancer and prostatic diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Neal ShoreCarolina Urologic Research Center, AUC Urology Specialists, Myrtle Beach, SC, USA. nshore@auclinics.com.ORCID http://orcid.org/0000-0001-5767-0548
Alicia K MorgansDana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0002-6563-4587
Noman ParachaBayer HealthCare Pharmaceuticals, Inc, Basel, Switzerland.
Elaine GallagherBayer HealthCare Pharmaceuticals, Inc, Basel, Switzerland.
Howard ThomClifton Insight, Bristol, UK.
David AceitunoClifton Insight, Bristol, UK.
Philip OrishabaClifton Insight, Bristol, UK.
Stephen StefaniCaixa de Previdência e Assistência dos Servidores da Fundação Nacional de Saúde (CAPESESP), Rio de Janeiro, Brazil.
Quoc-Dien TrinhDepartment of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Christopher J D WallisDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-5990-4026
Keith R AbramsDepartment of Statistics & Warwick Medical School, University of Warwick, Coventry, UK.
Martin BoegemannUniversity of Muenster Medical Center, Department of Urology, Muenster, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the proven efficacy of androgen deprivation therapy (ADT) combined with androgen receptor pathway inhibitors (ARPIs) in metastatic castration-sensitive prostate cancer (mCSPC), many patients still receive ADT monotherapy due to safety concerns. This reliance on ADT monotherapy underscores the need for education on the comparative effectiveness and safety of available therapies versus ADT. We evaluated the efficacy and safety of alternative treatment combinations, incorporating final data from the recent ARANOTE Phase III trial.

methodsWe conducted network meta-analysis (NMA) to evaluate progression-free survival (PFS) and overall survival (OS), incorporating heterogeneity assessment through subgroup analyses. Additionally, we performed a separate class effect NMA. We analysed grade 3-5 adverse events (AEs), serious AEs, and discontinuation due to AEs. We estimated hazard ratios (HRs) for efficacy, rate ratios (RRs) for safety, 95% credible intervals (CrI), and the surface under the cumulative ranking area (SUCRA) to rank treatments by efficacy and safety.

resultsDarolutamide (DAR) + docetaxel (DOC) + ADT showed the highest effect size [HR of 0.27 (95% CrI: 0.18, 0.39)] and the highest ranking (SUCRA: 0.97) across the base case and several subgroups on the PFS outcome. On OS, DAR + DOC + ADT similarly achieved the lowest HR of 0.52 (0.43, 0.64) and the highest ranking (SUCRA of 0.95). Safety analyses showed that grade 3-5 AEs were more frequent with docetaxel combinations, with ABI + DOC + ADT having the highest risk of grade 3-5 AEs. DAR + ADT was ranked best on all safety outcomes, outperforming other doublets and comparable to ADT monotherapy.

conclusionsThis NMA supports the superior efficacy of ARPI combinations against ADT monotherapy, for both OS and PFS. While DAR + ADT demonstrated comparable efficacy to other doublet combinations, it offered a superior safety profile, making it an effective and safe option for managing patients with mCSPC.

Indexed as

Androgen AntagonistsAndrogen Receptor AntagonistsAntineoplastic Combined Chemotherapy ProtocolsProstatic Neoplasms, Castration-ResistantHumansMaleNeoplasm MetastasisTreatment OutcomeAndrogen AntagonistsAndrogen Receptor Antagonists

Identifiers

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Registered trials

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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.