Evidence map›Paper›PMID 36509931›Full record

SynthesisProstate cancer and prostatic diseases2023

Therapeutic sensitivity to standard treatments in BRCA positive metastatic castration-resistant prostate cancer patients-a systematic review and meta-analysis.

Tamás Fazekas, Ádám D Széles, Brigitta Teutsch, Anita Csizmarik, Bálint Vékony, Alex Váradi, Tamás Kói, Zsolt Lang, Nándor Ács, Zsolt Kopa and 5 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Prostate cancer and prostatic diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Review
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Tamás FazekasDepartment of Urology, Semmelweis University, Budapest, Hungary.
Ádám D SzélesDepartment of Urology, Semmelweis University, Budapest, Hungary.
Brigitta TeutschCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.ORCID 0000-0002-9530-7886
Anita CsizmarikDepartment of Urology, Semmelweis University, Budapest, Hungary.
Bálint VékonyDepartment of Urology, Semmelweis University, Budapest, Hungary.ORCID 0000-0002-6814-7311
Alex VáradiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Tamás KóiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Zsolt LangCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Nándor ÁcsCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Zsolt KopaDepartment of Urology, Semmelweis University, Budapest, Hungary.
Péter HegyiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Boris HadaschikDepartment of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
Viktor GrünwaldDepartment of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.ORCID 0000-0003-2083-7687
Péter NyirádyDepartment of Urology, Semmelweis University, Budapest, Hungary.
Tibor SzarvasDepartment of Urology, Semmelweis University, Budapest, Hungary. szarvas.tibor@med.semmelweis-univ.hu.ORCID 0000-0002-6321-0799

Funding

Magyar Tudományos Akadémia (Hungarian Academy of Sciences) BO/00451/20/5
6 · The paper itself

Abstract

backgroundRecent oncology guidelines recommend BRCA1/2 testing for a wide range of prostate cancer (PCa) patients. In addition, PARP inhibitors are available for mutation-positive metastatic castration-resistant PCa (mCRPC) patients following prior treatment with abiraterone, enzalutamide or docetaxel. However, the question of which of these standard treatments is the most effective for BRCA1/2 positive mCRPC patients remains to be answered. The aim of this meta-analysis was to assess the efficacy of abiraterone, enzalutamide and docetaxel in BRCA1/2 mutation-positive mCRPC patients in terms of PSA-response (PSA50), progression-free survival (PFS) and overall survival (OS).

methodsAs no interventional trials are available on this topic, we performed the data synthesis of BRCA1/2 positive mCRPC patients by using both proportional and individual patient data. For PSA50 evaluation, we pooled event rates with 95% confidence intervals (CI), while for time-to-event (PFS, OS) analyses we used individual patient data with random effect Cox regression calculations.

resultsOur meta-analysis included 16 eligible studies with 348 BRCA1/2 positive mCRPC patients. In the first treatment line, response rates for abiraterone, enzalutamide and docetaxel were 52% (CI: 25-79%), 64% (CI: 43-80%) and 55% (CI: 36-73%), respectively. Analyses of individual patient data revealed a PFS (HR: 0.47, CI: 0.26-0.83, p = 0.010) but no OS (HR: 1.41, CI: 0.82-2.42, p = 0.210) benefit for enzalutamide compared to abiraterone-treated patients.

conclusionsOur PSA50 analyses revealed that all the three first-line treatments have therapeutic effect in BRCA1/2 positive mCRPC; although, based on the results of PSA50 and PFS analyses, BRCA positive mCRPC patients might better respond to enzalutamide treatment. However, molecular marker-driven interventional studies directly comparing these agents are crucial for providing higher-level evidence.

Indexed as

Prostatic Neoplasms, Castration-ResistantBenzamidesBRCA1 ProteinBRCA2 ProteinDocetaxelHumansMaleNitrilesPhenylthiohydantoinRetrospective StudiesTreatment OutcomeBenzamidesBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, humanDocetaxelenzalutamideNitrilesPhenylthiohydantoin

Identifiers

PMID36509931
PMCPMC10638083

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.