Talazoparib plus enzalutamide (TALA + ENZA) has demonstrated antitumor activity in the phase 3 clinical trial (TALAPRO-2; NCT03395197) as first-line (1L) therapy in men with asymptomatic or mildly symptomatic metastatic castration-resistant prostate cancer (mCRPC). Although many active interventions are available, randomized controlled trials (RCTs) involving talazoparib have only been conducted to assess its efficacy and safety compared to enzalutamide. To estimate comparisons between all relevant interventions, indirect comparisons are needed.
To estimate the comparative efficacy and safety of TALA + ENZA in 1L patients with mCRPC by conducting a systematic literature review and network meta-analyses (NMAs).
Databases were searched using Ovid, along with several gray literature sources to identify RCTs evaluating treatments in 1L mCRPC (PROSPERO registration: CRD42021283512). Feasibility assessment evaluated trial suitability for NMA inclusion and Bayesian or frequentist NMAs were conducted for evaluable efficacy and safety outcomes, respectively.
Thirty-three RCTs met the eligibility criteria and were feasible for NMAs. Across multiple efficacy outcomes assessed, except for overall survival (OS), TALA + ENZA was ranked the most efficacious treatment. For OS, TALA + ENZA showed the second-highest probability of being the most effective treatment; second to docetaxel 50 mg plus prednisolone 10 mg. With respect to safety outcomes, TALA + ENZA, in general, showed increased rates of hematological adverse events.
TALA + ENZA showed favorable results across multiple efficacy endpoints, but not across hematological toxicities compared with other 1L treatments in asymptomatic or mildly symptomatic mCRPC in the all-comers patient population.
The oncologist. 2024 Oct 19 [Epub ahead of print]
Elena Castro, Jenna Ellis, Samantha Craigie, Anja Haltner, Jonathan Nazari, Alexander Niyazov, Imtiaz A Samjoo
Hospital Universitario 12 de Octubre, Madrid 28041, Spain., EVERSANA™, Burlington, ON, Canada L7N 3H8., EVERSANA™, Chicago, IL 60601, United States., Pfizer, Inc., New York, NY 10001, United States.