SynthesisProstate cancer and prostatic diseases2022
Overall survival and adverse events after treatment with darolutamide vs. apalutamide vs. enzalutamide for high-risk non-metastatic castration-resistant prostate cancer: a systematic review and network meta-analysis.
Synthesis in Prostate cancer and prostatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- The efficacy and safety of enzalutamide in metastatic hormone-sensitive prostate cancer: a meta-analysis based on subgroups and reconstructed individual patient data.International urology and nephrology · 2026Pooled it
- The efficacy and safety of darolutamide combination therapy in advanced prostate cancer: a systematic review and meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2026Pooled it
- Safety profile of darolutamide versus placebo: a systematic review and meta-analysis.Prostate cancer and prostatic diseases · 2024Pooled it
- Based on ARASENS trial: efficacy and safety of darolutamide as an emerging option of endocrinotherapy for metastatic hormone-sensitive prostate cancer-an updated systematic review and network meta-analysis.Journal of cancer research and clinical oncology · 2023Pooled it
- The efficacy and adverse events of conventional and second-generation androgen receptor inhibitors for castration-resistant prostate cancer: A network meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Heterogeneity of urinary system tumors: novel avenues for targeted therapy and precision medicine.Journal of advanced research · 2026Review
- Real-world analysis of androgen receptor inhibitors in US patients with nonmetastatic castration-resistant prostate cancer: DEAR-EXT study.Prostate cancer and prostatic diseases · 2026Article
- Assessing the efficacy of darolutamide in metastatic hormone-sensitive prostate cancer based on subgroup meta-analysis and reconstructed individual patient data.Discover oncology · 2025Article
- Heart Failure Induced by Darolutamide in an Older Patient With M0 Castration-Resistant Prostate Cancer: A Case Report.IJU case reports · 2025Article
- Packing the Punch: Current and Emerging Treatment Strategies in Metastatic Castration-Sensitive Prostate Cancer.Current urology reports · 2025Review
- Adverse events of androgen receptor pathway inhibitors in prostate cancer from real world data.PloS one · 2025Article
- Severe cutaneous adverse reactions associated with second-generation androgen receptor antagonists in prostate cancer patients.PloS one · 2025Article
- Apalutamide: A Cause of Neutropenic Sepsis.Cureus · 2024Article
- PSA as the driving biomarker to manage low- and intermediate-risk prostate cancer patients in clinical practice.Asian journal of andrology · 2024Article
- Article
- [First clinical and oncological experiences with triplet therapy for high-volume metastatic hormone-sensitive prostate cancer].Urologie (Heidelberg, Germany) · 2024Article
- The mFrontiers in pharmacology · 2024Review
- [Androgen deprivation therapy plus chemotherapy ± androgen receptor-targeting agents for metastatic hormone-sensitive prostate cancer].Urologie (Heidelberg, Germany) · 2023Review
- Cost-Utility Analysis of Darolutamide Combined with Androgen Deprivation Therapy for Patients with High-Risk Non-Metastatic Castration-Resistant Prostate Cancer in China.Advances in therapy · 2023Article
- Best of 2022 in prostate cancer and prostatic diseases.Prostate cancer and prostatic diseases · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
15 authors at 5 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe most recent overall survival (OS) and adverse event (AE) data have not been compared for the three guideline-recommended high-risk non-metastatic castration-resistant prostate cancer (nmCRPC) treatment alternatives.
methodsWe performed a systematic review and network meta-analysis focusing on OS and AE according to the most recent apalutamide, enzalutamide, and darolutamide reports. We systematically examined and compared apalutamide vs. enzalutamide vs. darolutamide efficacy and toxicity, relative to ADT according to PRISMA. We relied on PubMed search for most recent reports addressing prospective randomized trials with proven predefined OS benefit, relative to ADT: SPARTAN, PROSPER, and ARAMIS. OS represented the primary outcome and AEs represented secondary outcomes.
resultsOverall, data originated from 4117 observations made within the three trials that were analyzed. Regarding OS benefit relative to ADT, darolutamide ranked first, followed by enzalutamide and apalutamide, in that order. In the subgroup of PSA-doubling time (PSA-DT) ≤ 6 months patients, enzalutamide ranked first, followed by darolutamide and apalutamide in that order. Conversely, in the subgroup of PSA-DT 6-10 months patients, darolutamide ranked first, followed by apalutamide and enzalutamide, in that order. Regarding grade 3+ AEs, darolutamide was most favorable, followed by enzalutamide and apalutamide, in that order.
conclusionThe current network meta-analysis suggests the highest OS efficacy and lowest grade 3+ toxicity for darolutamide. However, in the PSA-DT ≤ 6 months subgroup, the highest efficacy was recorded for enzalutamide. It is noteworthy that study design, study population, and follow-up duration represent some of the potentially critical differences that distinguish between the three studies and remained statistically unaccounted for using the network meta-analysis methodology. Those differences should be strongly considered in the interpretation of the current and any network meta-analyses.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.