title: Abiraterone or Enzalutamide in Advanced Castration-Resistant Prostate Cancer: An Indirect Comparison.
abstract: BACKGROUND
  To perform a comparative effectiveness analyses between enzalutamide and abiraterone acetate in both the pre-docetaxel and post-docetaxel settings based on published phase III randomized trials.
  
  
  METHODS
  The primary measure of efficacy was the posterior probability that enzalutamide outperforms abiraterone acetate (AA) with prednisone in terms of overall survival (OS) on average. Indirect meta-estimates were generated from four randomized studies in the context of a Bayesian hierarchical model with study-specific efficacy estimates meta-analyzed on the log scale.
  
  
  RESULTS
  We found weak evidence that enzalutamide outperforms AA with prednisone in terms of OS in the pre-docetaxel and post-docetaxel settings. However, we found strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS, time until PSA progression, and PSA response rate in both the pre- and post-docetaxel settings. Rates of grade 3 or worse adverse events were broadly similar between treatment (enzalutamide or AA) and control arms (placebo or placebo with prednisone) in all included randomized studies.
  
  
  CONCLUSIONS
  There is strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS and PSA progression and PSA response rate but not OS in the pre and post-docetaxel settings. These results may further guide clinicians in making treatment recommendations for patients with advanced prostate cancer. Prostate 77: 639-646, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Medical Oncology, Johns Hopkins Singapore International Medical Centre, Singapore.
authors.forename: Akhil
authors.initials: A
authors.lastname: Chopra
authors.affiliation: H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Georgia.
authors.forename: Mina
authors.initials: M
authors.lastname: Georgieva
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Lopes
authors.affiliation: Department of Medical Oncology, Johns Hopkins Singapore International Medical Centre, Singapore.
authors.forename: Chong Ming
authors.initials: CM
authors.lastname: Yeo
authors.affiliation: H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Georgia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Haaland
mesh_terms: D000736:Androstenes / Q000627:therapeutic use*; D001549:Benzamides; D017326:Clinical Trials, Phase III as Topic / Q000379:methods; D006801:Humans; D008297:Male; D009570:Nitriles; D010669:Phenylthiohydantoin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D064129:Prostatic Neoplasms, Castration-Resistant / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D015996:Survival Rate / Q000639:trends
chemical_list: D000736:Androstenes; D001549:Benzamides; D009570:Nitriles; D010669:Phenylthiohydantoin; C540278:enzalutamide; C089740:abiraterone
keywords: abiraterone; advanced prostate cancer; castrate-resistant; enzalutamide