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Comment & Response
May 13, 2021

Considerations Regarding a Network Meta-analysis of Systemic Treatments for Metastatic Castration-Sensitive Prostate Cancer

Author Affiliations
  • 1Department of Urology, Kyoto University Graduate School of Medicine, Kyoto city, Kyoto, Japan
  • 2Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
JAMA Oncol. 2021;7(7):1068-1069. doi:10.1001/jamaoncol.2021.0963

To the Editor In a systematic review and network meta-analysis (NMA), Wang et al1 compared the effectiveness and safety in randomized clinical trials of systemic treatments for metastatic castration-sensitive prostate cancer. As the authors pointed out, this review was updated and informative compared with previous ones in terms of including the most recent ARCHES trial2 and evaluating drug safety. The results of overall survival (OS) for abiraterone acetate, apalutamide, and docetaxel were similar to those in a previous NMA,3 except for enzalutamide, which was suggested to be the most effective treatment in that NMA. The authors1 considered that the difference was caused by including the ARCHES trial,2 which showed no benefit in OS compared with placebo. This could be one major reason; however, we think some other reasons may be worth mentioning.

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