Background

Both docetaxel and androgen-receptor-axis-targeted (ARAT) agents are approved in metastatic castration-sensitive prostate cancer (mCSPC) patients. Predictive factors of therapy efficacy are lacking.

Methods

We included articles reporting data about randomized-controlled clinical trials (RCTs) testing an ARAT agent plus ADT vs. ADT. We aimed to obtain pooled estimates of efficacy outcomes and assess differences in pooled estimates of efficacy outcomes between sub-groups.

Results

A total of 5427 mCSPC patients enrolled in five RCTs were evaluable for OS (Overall Survival) and PFS (Progression-free survival). Pooled OS-HR (Hazard Ratio) was 0.66 (95 % CI: 0.60−0.74), while pooled PFS-HR was 0.46 (95 % CI: 0.40−0.53). Combined treatment with docetaxel was associated with differential OS outcomes, while tumor volume according to the CHAARTED criteria and visceral metastasis were associated with differential PFS outcomes.

Conclusion

Our results add evidence that ARAT agents improve OS in mCSPC and discourage their combined use with docetaxel in this setting.

中文翻译：

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雄激素受体轴靶向疗法在转移性去势敏感性前列腺癌患者中的疗效预测指标：系统评价和荟萃分析。

背景

多西他赛和雄激素受体靶向药均被批准用于转移性去势敏感性前列腺癌（mCSPC）患者。缺乏治疗效果的预测因素。

方法

我们收录的文章报告了有关测试ARAT药物加ADT与ADT的随机对照临床试验（RCT）数据。我们旨在获得疗效结果的汇总估计，并评估各亚组之间疗效结果的汇总估计之间的差异。

结果

共有5427名mCSPC患者参加了5个RCT，可评估OS（总体生存期）和PFS（无进展生存期）。合并OS-HR（危险比）为0.66（95％CI：0.60-0.74），而合并PFS-HR为0.46（95％CI：0.40-0.53）。多西他赛联合治疗与OS的预后差相关，而按照CHAARTED标准进行的肿瘤大小和内脏转移与PFS的预后差相关。

结论

我们的研究结果证明，在这种情况下，ARAT药物可改善mCSPC中的OS，并阻止其与多西他赛联合使用。