Comparing the Clinical Efficacy and Safety of Abiraterone and Enzalutamide in Metastatic CRPC.

[pjoshea13]

New meta-analysis below [1], comparing Abiraterone [Zytiga] and Enzalutamide [Xtandi].

"Fourteen cohort studies involving 3469 participants were included."

PSA "response was higher for patients receiving enzalutamide than abiraterone (790 patients, odds ratio (OR) 0.47 ..."

"Enzalutamide was significantly associated with increased adverse events rate in comparison with abiraterone (730 patients, OR 0.35 ..."

"Enzalutamide was significantly associated with increased fatigue risk in comparison with abiraterone (2477 patients, OR 0.46 ..."

No mention of mean/median times to failure; effect on PCa/overall survival; treatment-emergent mutations, etc.

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/325...

J Oncol Pharm Pract

. 2020 Jun 12;1078155220929414. doi: 10.1177/1078155220929414. Online ahead of print.

Comparing the Clinical Efficacy and Safety of Abiraterone and Enzalutamide in Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis

Xin Wang 1 , Hui Yang 1 , Xiaopeng Hu 2 , Wei Wang 2 , Xiaojia Yu 1 , Shihui Wang 1 , Xiaodong Zhang 2 , Lihong Liu 1

Affiliations collapse

Affiliations

1 Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

2 Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

PMID: 32529950 DOI: 10.1177/1078155220929414

Abstract

Background: Two new drugs, abiraterone and enzalutamide, had recently shown beneficial effects on survival in patients with metastatic castration-resistant prostate cancer. We systematically reviewed the efficacy and safety of abiraterone and enzalutamide in metastatic castration-resistant prostate cancer in real-world practice.

Methods: A search from PubMed, Web of Science, Cochrane, Embase was conducted up to 6 March 2019. Available articles from conferences were searched. The endpoint was prostate-specific antigen response, overall survival, progression-free survival, number of patients with any adverse event.

Results: Fourteen cohort studies involving 3469 participants were included. Pooled result showed that prostate-specific antigen response was higher for patients receiving enzalutamide than abiraterone (790 patients, odds ratio (OR) 0.47, 95% confidence interval (CI) 0.29-0.77, P = 0.003, I2=59%). Enzalutamide was significantly associated with increased adverse events rate in comparison with abiraterone (730 patients, OR 0.35, 95%CI 0.13-0.92, P = 0.03, I2=65%). There was no statistical difference between abiraterone and enzalutamide with respect to perceived cognitive impairments (1856 patients, OR 0.90, 95%CI 0.29-2.76, P = 0.85, I2=5%). Enzalutamide was significantly associated with increased fatigue risk in comparison with abiraterone (2477 patients, OR 0.46, 95%CI 0.34-0.63, P＜0.00001, I2=0%).

Conclusions: Our results demonstrated that enzalutamide was more efficacious than abiraterone for patients with metastatic castration-resistant prostate cancer, but was associated with a significantly elevated risk of side effects, particularly fatigue.

Keywords: Metastatic castration-resistant prostate cancer; abiraterone; enzalutamide; meta-analysis.

[monte1111]

Maybe we can alternate. Xtandi one day, and Zytiga the next.

[j-o-h-n in reply to monte1111]

Maybe alternate Zytiga one day Xtandi the next?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/14/2020 10:42 PM DST