The efficacy of abiraterone in metastatic hormone-sensitive prostate cancer: a stratified meta-analysis based on subgroups of low or high disease volume and reconstructed individual patient data.

IF 2.8 3区医学 Q2 ONCOLOGY

Expert Review of Anticancer Therapy Pub Date : 2025-09-01 Epub Date: 2025-06-26 DOI:10.1080/14737140.2025.2522981

Fuxun Zhang, Zhirong Luo, Qi Xue, Xuyan Guo, Qiang Fu, Yong Jiao, Wei Zhang, Yang Xiong, Pati-Alam Alisha, Uzoamaka Adaobi Okoli, Geng Zhang

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引用次数: 0

Abstract

Introduction: The efficacy of abiraterone in metastatic hormone-sensitive prostate cancer (mHSPC) across different disease volumes remains uncertain. This meta-analysis aims to clarify benefit of abiraterone in low- and high-volume mHSPC.

Research design and methods: Phase III randomized clinical trials of abiraterone were selected. Individual patient data (IPD) for overall survival (OS), progression-free survival (PFS), and cancer-specific survival were reconstructed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to assess the efficacy. Survival analysis was performed using Cox hazards model.

Results: Data for 3374 patients were analyzed. In the overall population, abiraterone improved OS (HR: 0.66, 95% CI 0.59-0.73) and PFS (HR: 0.51, 95% CI 0.45-0.58). Subgroup analyses showed consistent OS benefit of abiraterone across low- and high-volume subgroups (HR: 0.71 and 0.64), and PFS benefit in counterparts (HR: 0.49 and 0.46). Grade 1-2 adverse events were reduced in abiraterone group (RR 0.66), while grade 3-4 events increased (RR 1.33). The Kaplan-Meier curves showed that abiraterone significantly improved OS and PFS across all subgroups (All p < 0.05).

Conclusions: Adding abiraterone provided significant survival benefits in patients with mHSPC regardless of disease volume. Future investigation shouldvalidate these findings in real world setting.

Registration: PROSPERO: (CRD420251028079).

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阿比特龙治疗转移性激素敏感前列腺癌的疗效：基于低或高疾病量亚组和重建个体患者数据的分层荟萃分析

阿比特龙治疗转移性激素敏感前列腺癌（mHSPC）在不同疾病量中的疗效仍不确定。本荟萃分析旨在通过完整的分析集和重建的个体患者数据（IPD）来阐明阿比特龙在低容量和高容量亚组中的益处。研究设计与方法：选择阿比特龙的III期随机临床试验。重建总生存期（OS）、无进展生存期（PFS）和癌症特异性生存期的IPD。合并95%置信区间（ci）的风险比（hr）来评估疗效，95% ci的风险比（rr）来总结不良事件。基于重建IPD，采用Cox风险模型进行生存分析。异质性通过Cochran’s Q和I2进行评估。结果：对3182例患者的数据进行了分析。在总体人群中，阿比特龙改善了OS （HR: 0.66, 95% CI 0.59-0.73）和PFS （HR: 0.51, 95% CI 0.45-0.58）。亚组分析显示，阿比特龙在低容量和高容量亚组中的OS获益一致（HR: 0.71和0.64），而相应的PFS获益一致（HR: 0.49和0.46）。阿比特龙组1-2级不良事件减少（RR = 0.66）， 3-4级不良事件增加（RR = 1.33）。除了小容量亚组的PFS外，异质性较低。Kaplan-Meier曲线显示，阿比特龙显著改善了所有亚组的OS和PFS(所有p结论：无论疾病体积大小，添加阿比特龙均可显著改善mHSPC患者的生存。未来的研究应该旨在推动更多的个性化治疗，并在现实世界中验证这些发现。注册：普洛斯彼罗：；（CRD420251028079）。

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

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.