Evidence map›Paper›PMID 37142371›Full record

ArticleThe Lancet. Oncology2023

Abiraterone acetate plus prednisolone with or without enzalutamide for patients with metastatic prostate cancer starting androgen deprivation therapy: final results from two randomised phase 3 trials of the STAMPEDE platform protocol.

Gerhardt Attard, Laura Murphy, Noel W Clarke, Ashwin Sachdeva, Craig Jones, Alex Hoyle, William Cross, Robert J Jones, Christopher C Parker, Silke Gillessen and 46 more

Open access · hybridAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 8 pooled it
23.3field-weighted citation impact, top 1% of its field
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

60 citing papers in PubMed, 8 syntheses or guidelines pooled it, 90 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Comparative effectiveness of first-line systemic treatments for metastatic castration-resistant prostate cancer: a systematic review and network meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024
    Pooled it
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

56 authors at 20 institutions in 2 countries.

Gerhardt AttardCancer Institute, University College London, London, UK; University College London Hospitals, London, UK. Electronic address: g.attard@ucl.ac.uk.
Laura MurphyMedical Research Council Clinical Trials Unit, University College London, London, UK.
Noel W ClarkeChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
Ashwin SachdevaChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
Craig JonesChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
Alex HoyleChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
William CrossSt James's University Hospital, Leeds, UK.
Robert J JonesBeatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, UK.
Christopher C ParkerRoyal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK.
Silke GillessenOncology Institute of Southern Switzerland, Bellinzona, Switzerland; CH and Universita della Svizzera Italiana, Lugano, Switzerland.
Adrian CookMedical Research Council Clinical Trials Unit, University College London, London, UK.
Chris BrawleyMedical Research Council Clinical Trials Unit, University College London, London, UK.
Clare GilsonMedical Research Council Clinical Trials Unit, University College London, London, UK.
Hannah RushMedical Research Council Clinical Trials Unit, University College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK.
Hoda Abdel-AtyRoyal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK.
Claire L AmosMedical Research Council Clinical Trials Unit, University College London, London, UK.
Claire MurphyMedical Research Council Clinical Trials Unit, University College London, London, UK.
Simon ChowdhuryGuy's and St Thomas' NHS Foundation Trust, London, UK.
Zafar MalikClatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK.
J Martin RussellInstitute of Cancer Sciences, University of Glasgow, Glasgow, UK.
Nazia ParkarMedical Research Council Clinical Trials Unit, University College London, London, UK.
Cheryl PughMedical Research Council Clinical Trials Unit, University College London, London, UK.
Carlos Diaz-MontanaMedical Research Council Clinical Trials Unit, University College London, London, UK.
Carmel PezaroSingleton Hospital, Swansea, UK.
Warren GrantGloucestershire Oncology Centre, Cheltenham, UK.
Helen SaxbyTorbay and South Devon NHS Foundation Trust, Torbay, UK.
Ian PedleyNorthern Centre for Cancer Care, Newcastle upon Tyne, UK.
Joe M O'SullivanQueen's University Belfast, Belfast, UK.
Alison BirtleRosemere Cancer Centre, Royal Preston Hospital, Preston, UK.
Joanna GaleQueen Alexandra Hospital, Portsmouth, UK.
Narayanan SrihariShrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK.
Carys ThomasKent Oncology Centre, Maidstone, UK.
Jacob TanguayVelindre Cancer Centre, Cardiff, UK.
John WagstaffSingleton Hospital, Swansea, UK.
Prantik DasRoyal Derby Hospital, Derby, UK.
Emma GrayYeovil District Hospital NHS Foundation Trust, Yeovil, UK.
Mymoona AlzouebiWeston Park Hospital, Sheffield, UK.
Omi ParikhEast Lancashire Hospitals NHS Trust, Preston, UK.
Angus RobinsonRoyal Sussex County Hospital, Brighton, UK.
Amir H MontazeriClatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK.
James WylieChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
Anjali ZarkarUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Richard CathomasDivision of Oncology and Hematology, Cantonal Hospital Graubünden, Chur, Switzerland; Swiss Group for Clinical Cancer Research, Bern, Switzerland.
Michael D BrownChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
Yatin JainChristie and Salford Royal NHS Foundation Trusts, Manchester, UK.
David P DearnaleyRoyal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK.
Malcolm D MasonCardiff University, Cardiff, UK.
Duncan GilbertMedical Research Council Clinical Trials Unit, University College London, London, UK.
Ruth E LangleyMedical Research Council Clinical Trials Unit, University College London, London, UK.
Robin MillmanMedical Research Council Clinical Trials Unit, University College London, London, UK.
David MathesonFaculty of Education Health and Wellbeing, University of Wolverhampton, Walsall, UK.
Matthew R SydesMedical Research Council Clinical Trials Unit, University College London, London, UK.
Louise C BrownMedical Research Council Clinical Trials Unit, University College London, London, UK.
Mahesh K B ParmarMedical Research Council Clinical Trials Unit, University College London, London, UK.
Nicholas D JamesRoyal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK.
STAMPEDE investigators
University College London · GBMedical Research Council · GBSalford Royal NHS Foundation Trust · GBSingleton Hospital · GBBeatson West of Scotland Cancer Centre · GBClatterbridge Cancer Centre NHS Foundation Trust · GBRoyal Marsden NHS Foundation Trust · GBQueen Alexandra Hospital · GBRoyal Preston Hospital · GBUniversity of Wolverhampton · GBGuy's and St Thomas' NHS Foundation Trust · GBKantonsspital Graubünden · CHRoyal Derby Hospital · GBUniversity Hospitals Birmingham NHS Foundation Trust · GBUniversity of Glasgow · GBVelindre Cancer Centre · GBCardiff University · GBEast Lancashire Hospitals NHS Trust · GBInstitute of Cancer Research · GBMaidstone Hospital · GB

Funding

Cancer Research UK CRUK_A12459Cancer Research UK CRUK_A22744Department of HealthMedical Research Council MC_UU_00004/01Medical Research Council MC_UU_12023/25Medical Research Council MRC_MC_UU_12023/25
6 · The paper itself

Abstract

backgroundAbiraterone acetate plus prednisolone (herein referred to as abiraterone) or enzalutamide added at the start of androgen deprivation therapy improves outcomes for patients with metastatic prostate cancer. Here, we aimed to evaluate long-term outcomes and test whether combining enzalutamide with abiraterone and androgen deprivation therapy improves survival.

methodsWe analysed two open-label, randomised, controlled, phase 3 trials of the STAMPEDE platform protocol, with no overlapping controls, conducted at 117 sites in the UK and Switzerland. Eligible patients (no age restriction) had metastatic, histologically-confirmed prostate adenocarcinoma; a WHO performance status of 0-2; and adequate haematological, renal, and liver function. Patients were randomly assigned (1:1) using a computerised algorithm and a minimisation technique to either standard of care (androgen deprivation therapy; docetaxel 75 mg/m

findingsBetween Nov 15, 2011, and Jan 17, 2014, 1003 patients were randomly assigned to standard of care (n=502) or standard of care plus abiraterone (n=501) in the abiraterone trial. Between July 29, 2014, and March 31, 2016, 916 patients were randomly assigned to standard of care (n=454) or standard of care plus abiraterone and enzalutamide (n=462) in the abiraterone and enzalutamide trial. Median follow-up was 96 months (IQR 86-107) in the abiraterone trial and 72 months (61-74) in the abiraterone and enzalutamide trial. In the abiraterone trial, median overall survival was 76·6 months (95% CI 67·8-86·9) in the abiraterone group versus 45·7 months (41·6-52·0) in the standard of care group (hazard ratio [HR] 0·62 [95% CI 0·53-0·73]; p<0·0001). In the abiraterone and enzalutamide trial, median overall survival was 73·1 months (61·9-81·3) in the abiraterone and enzalutamide group versus 51·8 months (45·3-59·0) in the standard of care group (HR 0·65 [0·55-0·77]; p<0·0001). We found no difference in the treatment effect between these two trials (interaction HR 1·05 [0·83-1·32]; p

interpretationEnzalutamide and abiraterone should not be combined for patients with prostate cancer starting long-term androgen deprivation therapy. Clinically important improvements in survival from addition of abiraterone to androgen deprivation therapy are maintained for longer than 7 years.

fundingCancer Research UK, UK Medical Research Council, Swiss Group for Clinical Cancer Research, Janssen, and Astellas.

Indexed as

Prostatic NeoplasmsProstatic Neoplasms, Castration-ResistantAbiraterone AcetateAndrogen AntagonistsAndrogensAntineoplastic Combined Chemotherapy ProtocolsBenzamidesClinical Trials, Phase III as TopicDocetaxelHumansMaleMeta-Analysis as TopicNitrilesPhenylthiohydantoinPrednisoloneRandomized Controlled Trials as TopicAbiraterone AcetateAndrogen AntagonistsAndrogensBenzamidesDocetaxelenzalutamideNitrilesPhenylthiohydantoinPrednisolone

Identifiers

PMID37142371
PMCPMC7616864
OpenAlexW4367693912

What OpenQuestion holds

Textmetadata
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.