Efficacy of enzalutamide and apalutamide in the treatment of non-metastasic castration-resistant prostate cancer: Indirect comparison

Actas Urol Esp (Engl Ed). 2019 Sep;43(7):355-363. doi: 10.1016/j.acuro.2019.03.007. Epub 2019 May 24.
[Article in English, Spanish]

Abstract

Objectives: To perform an adjusted indirect comparison of the efficacy of enzalutamide and apalutamide in patients with non-metastatic castration-resistant prostate cancer (nmCRPC) with a high risk of progression to metastatic disease.

Material and methods: After carrying out a literature search, we performed an adjusted indirect comparison (Bucher et al.) of the relative efficacy of enzalutamide and apalutamide in patients with nmCRPC with a high risk of progression to metastatic disease. The outcomes included were metastasis-free survival (MFS) and PSA response rate (PSARR).

Results: There were no statistically significant differences between enzalutamide and apalutamide regarding the analysed outcomes. For the comparison enzalutamide+ADT vs. apalutamide+ADT: MFS a HR (95% CI)=1,036 (0.781-1.373) was obtained. For PSARR, a RR (95% CI)=0.81 (0.339-1.938) was obtained.

Conclusions: The adjusted indirect comparison performed in this study shows that there are no statistically significant differences in terms of efficacy regarding MFS and PSARR between enzalutamide+ADT and apalutamide+ADT in patients with nmCRPC with a high risk of progression to metastatic disease. However, in order to confirm these results, an independent trial with direct comparison between both drugs would be required.

Keywords: Apalutamida; Apalutamide; Comparación indirecta; Cáncer de próstata; Enzalutamida; Enzalutamide; Indirect comparison; Metastasis-free survival; Prostate cancer; Supervivencia libre de metástasis.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Benzamides
  • Disease Progression
  • Humans
  • Male
  • Neoplasm Metastasis
  • Nitriles
  • Phenylthiohydantoin / analogs & derivatives*
  • Phenylthiohydantoin / therapeutic use
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Risk Assessment
  • Thiohydantoins / therapeutic use*
  • Treatment Outcome

Substances

  • Benzamides
  • Nitriles
  • Thiohydantoins
  • apalutamide
  • Phenylthiohydantoin
  • enzalutamide