INTRODUCTION: This study aims to make an indirect comparison between enzalutamide and abiraterone acetate for mCRPC post-docetaxel.
METHODS: A search for published phase 3 trials was performed with PubMed. Indirect comparisons of enzalutamide (AFFIRM) to abiraterone acetate (COU-AA-301) on outcomes overall survival (OS), time to prostate-specific-antigen (PSA) progression, radiographic progression-free survival (PFS), and PSA response were constructed in the context of log-linear regression models.
RESULTS: There was no statistically significant difference in OS (hazard ratio (HR) 0.85, 95% CI 0.68-1.07). However, there was some evidence that enzalutamide may outperform abiraterone acetate with respect to secondary outcomes: time to PSA progression (HR 0.40, 95% CI 0.30-0.53), radiographic PFS (HR 0.61, 95% CI 0.50-0.74), and PSA response rates (RRs) (OR 10.69, 95% CI 3.92-29.20).
CONCLUSION: While there was no statistically significant difference in OS, enzalutamide may be advantageous for secondary endpoints. Findings of this indirect comparison serve to be hypothesis-generating for future head-to-head trials.
Written by:
Tan PS, Haaland B, Montero AJ, Kyriakopoulos CE, Lopes G. Are you the author?
Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore; Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore; Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA; Hospital do Coração Cancer Center (HCor Onco), Brazil; Centro Paulista de Oncologia, Brazil; Oncoclinicas do Brasil, Brazil; Johns Hopkins University, Baltimore, MD, USA.
Reference: Clin Med Insights Oncol. 2014 Mar 16;8:29-36.
doi: 10.4137/CMO.S13671
PubMed Abstract
PMID: 24678245
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