The optimal treatment of metastatic hormone-naive prostate cancer: abiraterone acetate or docetaxel?

Abstract

Aim: To determine whether abiraterone acetate or docetaxel should be regarded as the current standard of care for metastatic hormone-naive prostate cancer (mHNPC). Methods & materials: A network meta-analysis (NMA) using the frequentist approach and generalized pairwise modeling was computed. Results: The results of this NMA favored abiraterone acetate over docetaxel-based regimens (hazard ratio: 0.79; 95% CI: 0.64–0.99) in patients with mHNPC. The results also suggest a reconsideration of the role of prednisone in view of the absence of a survival benefit (hazard ratio: 0.98; 95% CI: 0.59–1.65) with its use. Conclusion: Despite the paucity of direct comparative evidence, the results of this NMA favor the use of abiraterone acetate in the first-line treatment of mHNPC.