Overall Survival With Second-Generation Androgen-Receptor Signaling Inhibitors in Patients With Metastatic Castration Resistant Prostate Cancer: An Umbrella Review
Author(s)
Paridhi Jain, BSc, MSc1, Shakshi Sharma, MPharm2, Immaculate F. Nevis, MBA, MSc, PhD, MD3.
1ICON Global HEOR, Bangalore, India, 2ICON plc, Bangalore, India, 3Lead Consultant, ICON plc, Fort Johnson, NY, USA.
1ICON Global HEOR, Bangalore, India, 2ICON plc, Bangalore, India, 3Lead Consultant, ICON plc, Fort Johnson, NY, USA.
OBJECTIVES: Several literature reviews have been conducted evaluating the survival outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) on second-generation androgen-receptor signaling inhibitors (SGARIs). This umbrella review aimed to synthesize evidence on the overall survival (OS), radiographic progression free survival (rPFS) and health-related quality of life (HRQoL) in such patients.
METHODS: Literature reviews of randomized controlled trials (RCTs) examining OS, rPFS, and HRQoL in patients with mCRPC on SGARIs were identified through a literature search in MEDLINE, EMBASE and Cochrane Database from inception until 31 May 2025.
RESULTS: In total seven reviews were included in this review, of which six review examined the efficacy of SGARIs in patients with mCRPC and one reported HRQoL. Of the six reviews, four reported significant prolonging of OS and rPFS in patients on enzalutamide and abiraterone compared with placebo, whereas the remaining two reviews reported significant results for rPFS among patients using combination therapies of olaparib+abiraterone and AKT inhibitor+SGARI. One review reported on HRQoL comparing patients on enzalutamide with abiraterone. This review reported better Functional Assessment of Cancer Therapy-Prostate (FACT-P) scores with abiraterone than enzalutamide. The RCTs included within the reviews were heterogeneous, possibly due to differences in eligibility criteria, follow-up period, and differing patient characteristics. A critical appraisal of the reviews was conducted using the AMSTAR-2 tool which resulted in ‘moderate’ quality of all included reviews.
CONCLUSIONS: Majority of the included reviews reported better OS and rPFS with SGARIs (alone or in combination) compared with placebo in patients with mCRPC.
METHODS: Literature reviews of randomized controlled trials (RCTs) examining OS, rPFS, and HRQoL in patients with mCRPC on SGARIs were identified through a literature search in MEDLINE, EMBASE and Cochrane Database from inception until 31 May 2025.
RESULTS: In total seven reviews were included in this review, of which six review examined the efficacy of SGARIs in patients with mCRPC and one reported HRQoL. Of the six reviews, four reported significant prolonging of OS and rPFS in patients on enzalutamide and abiraterone compared with placebo, whereas the remaining two reviews reported significant results for rPFS among patients using combination therapies of olaparib+abiraterone and AKT inhibitor+SGARI. One review reported on HRQoL comparing patients on enzalutamide with abiraterone. This review reported better Functional Assessment of Cancer Therapy-Prostate (FACT-P) scores with abiraterone than enzalutamide. The RCTs included within the reviews were heterogeneous, possibly due to differences in eligibility criteria, follow-up period, and differing patient characteristics. A critical appraisal of the reviews was conducted using the AMSTAR-2 tool which resulted in ‘moderate’ quality of all included reviews.
CONCLUSIONS: Majority of the included reviews reported better OS and rPFS with SGARIs (alone or in combination) compared with placebo in patients with mCRPC.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO174
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Clinician Reported Outcomes, Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology, Reproductive & Sexual Health