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Abiraterone or Enzalutamide in Advanced Castration‐Resistant Prostate Cancer: An Indirect Comparison
Author(s) -
Chopra Akhil,
Georgieva Mina,
Lopes Gilberto,
Yeo Chong Ming,
Haaland Benjamin
Publication year - 2017
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23309
Subject(s) - enzalutamide , docetaxel , medicine , prostate cancer , prednisone , abiraterone acetate , oncology , placebo , randomized controlled trial , urology , cancer , androgen deprivation therapy , pathology , androgen receptor , alternative medicine
BACKGROUND To perform a comparative effectiveness analyses between enzalutamide and abiraterone acetate in both the pre‐docetaxel and post‐docetaxel settings based on published phase III randomized trials. METHODS The primary measure of efficacy was the posterior probability that enzalutamide outperforms abiraterone acetate (AA) with prednisone in terms of overall survival (OS) on average. Indirect meta‐estimates were generated from four randomized studies in the context of a Bayesian hierarchical model with study‐specific efficacy estimates meta‐analyzed on the log scale. RESULTS We found weak evidence that enzalutamide outperforms AA with prednisone in terms of OS in the pre‐docetaxel and post‐docetaxel settings. However, we found strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS, time until PSA progression, and PSA response rate in both the pre‐ and post‐docetaxel settings. Rates of grade 3 or worse adverse events were broadly similar between treatment (enzalutamide or AA) and control arms (placebo or placebo with prednisone) in all included randomized studies. CONCLUSIONS There is strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS and PSA progression and PSA response rate but not OS in the pre and post‐docetaxel settings. These results may further guide clinicians in making treatment recommendations for patients with advanced prostate cancer. Prostate 77: 639–646, 2017 . © 2017 Wiley Periodicals, Inc.