Summary

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• This summary is based on the review of 19 systematic review(s)/meta-analysis(es). ^[1-19]
• Abiraterone acetate (AA) combined with androgen deprivation therapy (ADT) significantly improves overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC), with a hazard ratio (HR) of 1.568 (95% credible interval (CrI): 1.378-1.773) for the general population, and HR of 1.164 (95% CrI: 1.348-1.924) for high-volume disease subgroups.
• In high-risk non-metastatic prostate cancer, AA combined with prednisolone significantly prolongs metastasis-free survival (MFS) compared to ADT alone, with an HR of 0.53 (95% confidence interval (CI): 0.44-0.64, p<0.0001).
• The combination of AA with prednisolone also significantly improves prostate cancer-specific survival (PCSS) compared to ADT alone, yielding an HR of 0.49 (95% CI: 0.37-0.65, p<0.0001).
• Enzalutamide demonstrates superior prostate-specific antigen progression-free survival (PSA-PFS) (HR=0.365, 95% CI: 0.303-0.441) and time to PSA progression (TTPP) (HR=0.19, 95% CI: 0.17-0.22) compared to AA in metastatic castration-resistant prostate cancer (mCRPC) patients.
• Fracture Incidence: Patients receiving (223)Ra combined with abiraterone acetate (AA) showed a higher fracture incidence compared to non-hormonal anti-androgens (NHA) monotherapy (OR: 3.22, 95% CI: 2.24-4.63, P < 0.01).
• Adverse Events: The combination of AA with androgen deprivation therapy (ADT) is associated with an increased risk of grade III to V adverse events (RR 1.34, 95% CI 1.22 to 1.47), including more frequent occurrences of hypertension and alanine transaminitis.
• Serious Adverse Events (SAEs): There was no significant difference in the incidence of SAEs between abiraterone and enzalutamide in metastatic castration-resistant prostate cancer (mCRPC) (P=0.21, I(2 =) 38%).
• There is no population-type or subgroup information available in the reviewed studies.