Differential side effects profile in patients with mCRPC treated with abiraterone or enzalutamide: a meta-analysis of randomized controlled trials

Raphael B. Moreira; Marcio Debiasi; Edoardo Francini; Pier V. Nuzzo; Guillermo De Velasco; Fernando C. Maluf; Andre P. Fay; Joaquim Bellmunt; Toni K. Choueiri; Fabio A. Schutz

doi:10.18632/oncotarget.20028

Journal article

Differential side effects profile in patients with mCRPC treated with abiraterone or enzalutamide: a meta-analysis of randomized controlled trials

Raphael B. Moreira, Marcio Debiasi, Edoardo Francini, Pier V. Nuzzo, Guillermo De Velasco, Fernando C. Maluf, Andre P. Fay, Joaquim Bellmunt, Toni K. Choueiri and Fabio A. Schutz

Oncotarget, Vol.8(48), pp.84572-84578

10/13/2017

DOI: 10.18632/oncotarget.20028

PMID: 29137449

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Abstract

Background: Abiraterone and enzalutamide are currently approved for mCRPC patients. Both drugs have distinct mechanisms of action and may have different toxicity profile. There are limited data comparing the side effects of abiraterone and enzalutamide. We performed a meta-analysis of randomized controlled trials (RCT) to better characterize the risk of adverse events associated with both drugs. Methods: We performed a literature search on MEDLINE for studies reporting abiraterone and enzalutamide side effects from January 1966 to July 31, 2015. Abstracts presented at ASCO meetings from 2004 to 2015 were selected manually. Phase III RCT were included in analysis. We assessed the risk of adverse events reported in RCT by performing two meta-analyses: abiraterone-prednisone vs. placebo-prednisone (2,283 pts) and enzalutamide vs. placebo (2,914 pts). Summary of incidence, relative-risks (RR), and 95% confidence intervals (CI) were calculated using random-effects or fixed-effects models based on the heterogeneity of included studies. Results: Overall, enzalutamide was not associated with all-grade (RR 1.06 - 95% CI 0.67-1.65) or grade >= 3 (RR 0.81 - 95% CI 0.28-2.33) cardiovascular events, but was associated with increased risk of all-grade fatigue (RR 1.29 - 95% CI 1.15-1.44). On the other hand, abiraterone was associated with increased risk of all-grade (RR 1.28 - 95% CI 1.06-1.55) and grade >= 3 (RR 1.76 - 95% CI 1.12-2.75) cardiovascular events, but was not associated with all-grade (RR 0.85 - 95% CI 0.58-1.23) or grade >= 3 (RR 1.07 - 95% CI 0.97-1.19) fatigue. Conclusions: In this meta-analysis, abiraterone was associated with an increased risk of cardiovascular events, while enzalutamide was associated with an increased risk of fatigue.

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Details

Title: Subtitle: Differential side effects profile in patients with mCRPC treated with abiraterone or enzalutamide: a meta-analysis of randomized controlled trials
Creators: Raphael B. Moreira - Hospital Alemão Oswaldo Cruz
Marcio Debiasi - Pontifícia Universidade Católica do Rio Grande do Sul
Edoardo Francini - Harvard University
Pier V. Nuzzo - Harvard University
Guillermo De Velasco - Harvard University
Fernando C. Maluf - Beneficência Portuguesa de São Paulo
Andre P. Fay - Pontifícia Universidade Católica do Rio Grande do Sul
Joaquim Bellmunt - Dana-Farber Cancer Institute
Toni K. Choueiri - Dana-Farber Cancer Institute
Fabio A. Schutz - Beneficência Portuguesa de São Paulo
Resource Type: Journal article
Publication Details: Oncotarget, Vol.8(48), pp.84572-84578
DOI: 10.18632/oncotarget.20028
PMID: 29137449
ISSN: 1949-2553
eISSN: 1949-2553
Publisher: Impact Journals Llc
Number of pages: 7
Language: English
Date published: 10/13/2017
Academic Unit: Internal Medicine
Record Identifier: 9985221242202771

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