{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:54:13Z","timestamp":1784274853029,"version":"3.55.0"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T00:00:00Z","timestamp":1626825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To perform a systematic review and network meta\u2010analysis to compare the efficacy and safety of currently available treatments for the management of metastatic hormone\u2010sensitive prostate cancer (mHSPC), as there has been a paradigm shift with the use of next\u2010generation androgen receptor inhibitors (ARIs) and docetaxel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multiple databases were searched for articles published before May 2020 according to the Preferred Reporting Items for Systematic Review and Meta\u2010analysis extension statement for network meta\u2010analysis. Studies comparing overall\/progression\u2010free survival (OS\/PFS) and\/or adverse events (AEs) in patients with mHSPC were eligible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20099960) were selected, and formal network meta\u2010analyses were conducted. Abiraterone (hazard ratio [HR] 0.83, 95% credible interval [CrI] 0.76\u20130.90), docetaxel (HR 0.90, 95% CrI 0.82\u20130.98), and enzalutamide (HR 0.85, 95% CrI 0.73\u20130.99) were associated with significantly better OS than androgen\u2010deprivation therapy (ADT), and abiraterone emerged as the best option. Abiraterone (HR 0.71, 95% CrI 0.67\u20130.76), apalutamide (HR 0.73, 95% CrI 0.65\u20130.81), docetaxel (HR 0.84, 95% CrI 0.78\u20130.90), and enzalutamide (HR 0.67, 95% CrI 0.63\u20130.71) were associated with significantly better PFS than ADT, and enzalutamide emerged as the best option. Abiraterone (HR 0.85, 95% CrI 0.78\u20130.93), apalutamide (HR 0.87, 95% CrI 0.77\u20130.98), and enzalutamide (HR 0.80, 95% CrI 0.73\u20130.88) were significantly more effective than docetaxel. Regarding AEs, apalutamide was the likely best option among the three ARIs. In patients with low\u2010volume mHSPC, enzalutamide was the best option in terms of OS and PFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All three ARIs are effective therapies for mHSPC; apalutamide was the best tolerated. All three seemed more effective than docetaxel. These findings may facilitate individualised treatment strategies and inform future comparative trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15507","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T15:36:26Z","timestamp":1624635386000},"page":"423-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Systemic therapies for metastatic hormone\u2010sensitive prostate cancer: network meta\u2010analysis"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6147-6569","authenticated-orcid":false,"given":"Keiichiro","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Urology Medical University of Vienna Vienna Austria"},{"name":"Department of Urology The Jikei University School of Medicine Tokyo 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Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Quhal","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna Vienna Austria"},{"name":"Department of Urology King Fahad Specialist Hospital Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-0272","authenticated-orcid":false,"given":"Ekaterina","family":"Laukhtina","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna Vienna Austria"},{"name":"Institute for Urology and Reproductive Health Sechenov University Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor M.","family":"Schuettfort","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna Vienna Austria"},{"name":"Department of Urology University Medical Center Hamburg\u2010Eppendorf Hamburg 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Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Egawa","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna Vienna Austria"},{"name":"Institute for Urology and Reproductive Health Sechenov University Moscow Russia"},{"name":"Division of Urology Department of Special Surgery The University of Jordan Amman Jordan"},{"name":"Department of Urology Weill Cornell Medical College New York NY USA"},{"name":"Department of Urology University of Texas Southwestern Dallas TX 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