1. A meta-analysis on overall survival and safety outcomes in patients with nonmetastatic castration-resistant prostate cancer treated with novel hormonal agents
- Author
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Marco Oderda, Franco Morelli, Elena Taveri, Alessandro Rizzo, Matteo Santoni, Sara Merler, Giulia Sorgentoni, Benedetta Fragomeno, Francesco Massari, and Veronica Mollica
- Subjects
Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,nmCRPC ,Comorbidity ,Castration-Resistant ,law.invention ,Prostate cancer ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Internal medicine ,Nitriles ,Phenylthiohydantoin ,Androgen Receptor Antagonists ,medicine ,Humans ,Enzalutamide ,Pharmacology (medical) ,Adverse effect ,apalutamide ,darolutamide ,enzalutamide ,nonmetastatic ,Benzamides ,Prostatic Neoplasms, Castration-Resistant ,Pyrazoles ,Quality of Life ,Randomized Controlled Trials as Topic ,Thiohydantoins ,Pharmacology ,business.industry ,Apalutamide ,Prostatic Neoplasms ,medicine.disease ,Discontinuation ,Darolutamide ,chemistry ,Meta-analysis ,business - Abstract
Several novel androgen receptor (AR)-inhibitors have been introduced for nonmetastatic castration-resistant prostate cancer (nmCRPC) treatment, with the improvement of survival outcomes which need to be balanced against the risk of adverse events. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating enzalutamide, apalutamide and darolutamide in nmCRPC patients, to assess overall survival (OS), incidence and risk of adverse drug events, adverse-events-related death and adverse-events-related treatment discontinuation. We selected three RCTs (SPARTAN, PROSPER and ARAMIS). New hormonal agents administration resulted in better OS, despite the increased risk of several any grade and grade 3-4 adverse events. In the decision-making process, careful evaluation of expected adverse events, patients' comorbidities and maintenance of quality of life are mandatory.
- Published
- 2021