ReviewCureus2025
Comparative Effectiveness of Management Strategies for Stage IV Prostate Cancer: A Narrative Review.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Stage IV prostate cancer (PCa) refers to a disease that has metastasized beyond the prostate gland to distant sites, such as bones, visceral organs, or non-regional lymph nodes. While early attempts at curative therapy were occasionally made in oligometastatic cases, current guidelines uniformly recommend palliative-intent management once true metastatic spread is confirmed. Over the past decade, treatment paradigms have shifted from androgen deprivation therapy (ADT) monotherapy to earlier intensification with combination regimens including chemo-hormonal therapy and next-generation hormonal agents to improve survival and quality of life (QoL). This narrative review evaluates the comparative effectiveness of ADT, chemotherapy, novel hormonal agents, and palliative radiotherapy in patients with stage IV prostate cancer. A structured literature search of PubMed, Embase, and the Cochrane Library was conducted for English-language studies published between January 2015 and May 2025. Search terms included "stage IV prostate cancer," "metastatic prostate cancer," "androgen deprivation therapy," "docetaxel," "enzalutamide," "abiraterone," "palliative radiotherapy," and "systemic therapy." Eligible studies involved adult male patients with stage IV prostate cancer receiving systemic therapies or radiotherapy; preclinical studies, case reports, and non-metastatic populations were excluded. ADT remains the foundational therapy for metastatic disease. In hormone-sensitive, high-risk patients, combination therapy with agents such as enzalutamide or abiraterone has been shown to significantly improve progression-free survival (PFS) and overall survival (OS). Chemotherapy, particularly docetaxel, provides survival benefits in patients with high-volume metastatic hormone-sensitive disease, as demonstrated in landmark trials. Cabazitaxel, typically used in the castration-resistant setting, offers favorable tolerability compared to docetaxel rechallenge. Among novel hormonal agents, enzalutamide is often preferred in older or comorbid patients due to superior cost-effectiveness and a more favorable metabolic and cardiovascular profile compared to abiraterone. Palliative radiotherapy contributes to symptom control and local disease management, especially when guided by biomarkers such as circulating tumor cells (CTCs). However, variability in study design, patient characteristics, and prior treatments complicates direct comparisons. Managing stage IV prostate cancer requires an individualized, palliative-focused strategy. This review highlights the value of early combination approaches based on disease volume, patient performance status, comorbidities, and personal preferences. ADT remains the therapeutic cornerstone, with systemic intensification and selective radiotherapy offering additive benefits in appropriately chosen patients.
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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.