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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
  • 1Medical Oncology, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy
JAMA Oncol. 2021;7(7):1068. doi:10.1001/jamaoncol.2021.0960

To the Editor In a systematic review and network meta-analysis (NMA), Wang and colleagues1 pulled together 7 randomized clinical trials with a total of 7287 patients with metastatic castration-sensitive prostate cancer (mCSPC), suggesting that apalutamide and abiraterone acetate reported the most consistent survival benefits with an overall manageable safety profile. Interestingly, the authors used Bayesian NMA to optimize data extrapolation and to compare different treatments when no direct comparative trial exists; to try to compare evidence across trials, Wang et al used rigorous and well-accepted methods when conducting their study, also acknowledging several important limitations (eg, different follow-up durations and inconsistency in outcome measures). However, we believe some methodological aspects deserve specific discussion.

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