title: [Clinical efficacy and safety of enzalutamide in metastatic castration-resistant prostate cancer: systematic review and meta-analysis].
abstract: Enzalutamide, abiraterone-acetate, and cabazitaxel are licensed post-docetaxel treatments of metastatic castration-resistant prostate cancer (mCRPC) in Hungary. The objectives of the study were to assess the efficacy and safety of post-docetaxel enzalutamide treatment and to compare it with abiraterone and with cabazitaxel, using Medline-based systematic literature search, and meta-analysis of randomised controlled trials (RCT). Overall 3 RCTs were included, one for each substance. Compared to placebo, enzalutamide proved significant efficacy in each primary and secondary endpoint. Enzalutamide extended median overall survival by 4.8 months. Due to lack of a common comparator in the cabazitaxel trial, only enzalutamide and abiraterone were involved in an indirect comparison. No significant difference was identified either in the primary endpoint (overall survival) (HR: 0.97, 95% CI: 0.75-1.25) or in frequencies of adverse events between these two treatments. However, enzalutamide was significantly more efficacious than abiraterone in 3 secondary endpoints: time to prostate-specific antigen (PSA) progression (HR: 0.43, 95% CI: 0.31-0.59), radiographic progression-free survival (HR: 0.6, 95% CI: 0.5-0.72), and PSA response rate (RR: 7.48, 95% CI: 2.83-19.72). Enzalutamide therapy proved clinical efficacy and safety in patients with post-docetaxel mCRPC. In the indirect comparison, efficacy and safety of abiraterone and enzalutamide were found to be similar.
authors.affiliation: Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem, Budapest, Hungary. valentin.brodszky@uni-corvinus.hu.
authors.forename: Valentin
authors.initials: V
authors.lastname: Brodszky
authors.affiliation: Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem, Budapest, Hungary. valentin.brodszky@uni-corvinus.hu.
authors.forename: Márta
authors.initials: M
authors.lastname: Péntek
authors.affiliation: Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem, Budapest, Hungary. valentin.brodszky@uni-corvinus.hu.
authors.forename: Petra
authors.initials: P
authors.lastname: Baji
authors.affiliation: Klinikai Orvostudományok Doktori Iskola, Semmelweis Egyetem, Budapest, Hungary.
authors.forename: Fanni
authors.initials: F
authors.lastname: Rencz
authors.affiliation: C Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
authors.forename: Lajos
authors.initials: L
authors.lastname: Géczi
authors.affiliation: Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest, Hungary.
authors.forename: Miklós
authors.initials: M
authors.lastname: Szûcs
authors.affiliation: Urológiai Klinika, Debreceni Egyetem Orvos- és Egészségtudományi Centrum, Debrecen, Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Berczi
authors.affiliation: Egészségügyi Közgazdaságtan Tanszék, Budapesti Corvinus Egyetem, Budapest, Hungary. valentin.brodszky@uni-corvinus.hu.
authors.forename: László
authors.initials: L
authors.lastname: Gulácsi
mesh_terms: D000736:Androstenes; D000737:Androstenols / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001549:Benzamides; D001859:Bone Neoplasms / Q000188:drug therapy; D006801:Humans; D008297:Male; D009570:Nitriles; D010669:Phenylthiohydantoin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D016032:Randomized Controlled Trials as Topic; D043823:Taxoids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000736:Androstenes; D000737:Androstenols; D000970:Antineoplastic Agents; D001549:Benzamides; D009570:Nitriles; D043823:Taxoids; D010669:Phenylthiohydantoin; C552428:cabazitaxel; C540278:enzalutamide; D017430:Prostate-Specific Antigen; C089740:abiraterone