Comparing the safety and efficacy of systemic therapies for high-risk biochemically recurrent hormone-sensitive prostate cancer: a network meta-analysis
Bibliographic record
Abstract
Introduction: Enzalutamide is the only androgen receptor pathway inhibitor approved by the United States Food and Drug Administration and the European Medicines Agency to treat high-risk biochemically recurrent non-metastatic hormone-sensitive prostate cancer. The objective of this network meta-analysis was to provide indirect evidence of the efficacy of enzalutamide relative to other therapies for biochemical recurrence after definitive therapy. Materials and Methods: We conducted a systematic literature review to identify trials that assessed the efficacy and safety of current and emerging interventions. Outcomes of interest were metastasis-free survival, overall survival, time to prostate-specific antigen progression, time to castration resistance, proportion of patients with prostate-specific antigen <0.2 ng/ml at 36 (± 4) weeks of treatment, and grade ≥3 treatment-related adverse events. Fixed- and random-effects models were run under the Bayesian framework. Results: Enzalutamide with androgen-deprivation therapy (i.e., combination therapy) demonstrated superiority over most comparators for overall survival (except androgen-deprivation therapy + docetaxel, which was similar), and over all comparators for metastasis-free survival, time to prostate-specific antigen progression, and time to castration resistance. Enzalutamide combination therapy demonstrated superiority over enzalutamide monotherapy for all efficacy outcomes, and similar performance for safety. Enzalutamide monotherapy demonstrated superiority over androgen-deprivation therapy alone and androgen-deprivation therapy + docetaxel for metastasis-free survival and time to prostate-specific antigen progression. Treatment-related adverse events were least common for androgen-deprivation therapy alone. Discussion: This network meta-analysis provides evidence that enzalutamide combination therapy provides considerable oncological benefit in high-risk biochemically recurrent non-metastatic hormone-sensitive prostate cancer, albeit with a higher risk of treatment-related adverse events.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.049 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".