Talazoparib plus enzalutamide versus olaparib plus abiraterone acetate and niraparib plus abiraterone acetate for metastatic castration-resistant prostate cancer: a matching-adjusted indirect comparison.

IF 5.1 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2024-12-07 DOI:10.1038/s41391-024-00924-x

Elena Castro, Di Wang, Sarah Walsh, Samantha Craigie, Anja Haltner, Jonathan Nazari, Alexander Niyazov, Imtiaz A Samjoo

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引用次数: 0

Abstract

Background: Without head-to-head trials between talazoparib+enzalutamide (TALA + ENZA), olaparib+abiraterone acetate (OLAP + AAP), and niraparib plus AAP (NIRA + AAP) the ability to evaluate their relative efficacy as first-line (1 L) treatment in metastatic castration-resistant prostate cancer (mCRPC) is limited. The objective of this study was to assess the relative efficacy between TALA + ENZA (TALAPRO-2) versus OLAP + AAP (PROpel) and NIRA + AAP (MAGNITUDE) in 1 L mCRPC via a matching-adjusted indirect treatment comparison (MAIC).

Methods: Patient-level data from TALAPRO-2 and published data from PROpel and MAGNITUDE were used. TALAPRO-2 data were reweighted to satisfy the eligibility criteria for PROpel and MAGNITUDE. Talazoparib (0.5 mg/day) plus enzalutamide (160 mg/day) was compared to olaparib (300 mg twice daily) plus abiraterone acetate (1000 mg/day) and niraparib (200 mg/day) plus abiraterone acetate (1000 mg/day). Hazard ratios (HRs) were calculated for radiographic progression-free survival (rPFS) and overall survival (OS), and odds ratios (ORs) for prostate-specific antigen (PSA) response and objective response rate (ORR). Additional efficacy outcomes were assessed.

Results: In all-comers, TALA + ENZA was statistically superior to OLAP + AAP for rPFS (HR: 0.727; 95% confidence interval [CI]: 0.565, 0.935) and PSA response (OR: 1.663; 1.101, 2.510), and numerically favored for OS (HR: 0.847; 0.667, 1.076) and ORR (OR: 1.109; 0.646, 1.903). In patients with homologous recombination repair mutations (HRRm), relative to NIRA + AAP, TALA + ENZA was statistically superior for rPFS (HR: 0.460; 0.280, 0.754), and numerically favored for OS (HR: 0.601; 0.347, 1.041) and ORR (OR: 1.524; 0.579, 4.016).

Conclusions: Results suggest that TALA + ENZA may provide improvements in clinical outcomes relative to OLAP + AAP and NIRA + AAP in 1 L mCRPC; however, inherent limitations associated with the complexity of the analyses must be considered.

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塔拉唑帕尼加恩杂鲁胺与奥拉帕尼加醋酸阿比特龙和尼拉帕尼加醋酸阿比特龙治疗转移性去势抵抗性前列腺癌：一项匹配调整的间接比较

背景：在塔拉帕尼+恩杂鲁胺（TALA + ENZA）、奥拉帕尼+醋酸阿比特龙（OLAP + AAP）和尼拉帕尼+ AAP （NIRA + AAP）之间没有进行正面试验的情况下，评估它们作为转移性阉切抵抗性前列腺癌（mCRPC）一线（1l）治疗的相对疗效的能力是有限的。本研究的目的是通过匹配调整的间接治疗比较（MAIC），评估TALA + ENZA （TALAPRO-2）与OLAP + AAP （PROpel）和NIRA + AAP （MAGNITUDE）在1l mCRPC中的相对疗效。方法：采用来自talapo -2的患者水平数据以及来自PROpel和MAGNITUDE的已发表数据。TALAPRO-2数据重新加权以满足PROpel和MAGNITUDE的资格标准。将Talazoparib （0.5 mg/天）+ enzalutamide （160 mg/天）与olaparib （300 mg/天两次）+醋酸阿比特龙（1000 mg/天）和niraparib （200 mg/天）+醋酸阿比特龙（1000 mg/天）进行比较。计算放射无进展生存期（rPFS）和总生存期（OS）的风险比（hr），以及前列腺特异性抗原（PSA）反应和客观反应率（ORR）的优势比（ORs）。对其他疗效结果进行评估。结果：在所有患者中，TALA + ENZA在rPFS方面优于OLAP + AAP (HR: 0.727；95%置信区间[CI]: 0.565, 0.935)和PSA反应(OR: 1.663；1.101, 2.510)，在数字上更倾向于OS (HR: 0.847；0.667, 1.076)和ORR (OR: 1.109；0.646, 1.903)。在同源重组修复突变（HRRm）患者中，相对于NIRA + AAP， TALA + ENZA在rPFS方面具有统计学优势(HR: 0.460；0.280, 0.754)，在数值上更倾向于OS (HR: 0.601；0.347, 1.041)和ORR (OR: 1.524；0.579, 4.016)。结论：与OLAP + AAP和NIRA + AAP相比，TALA + ENZA可改善1l mCRPC患者的临床预后；然而，必须考虑与分析的复杂性相关的固有限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.