Matching-adjusted indirect comparison of talazoparib plus enzalutamide versus abiraterone acetate and docetaxel in mCRPC
Creators: name: Castro, Elena
name: Wang, Di
name: Walsh, Sarah
name: Craigie, Samantha
name: Haltner, Anja
name: Nazari, Jonathan
name: Niyazov, Alexander
name: Samjoo, Imtiaz A.
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Pharmacology
subject: Sociology
subject: FOS: Sociology
subject: Biological Sciences not elsewhere classified
subject: Cancer
subject: Science Policy

description: The absence of direct comparisons between talazoparib plus enzalutamide (TALA+ENZA) and current standard of care hinders evaluating their relative efficacy for first-line (1 L) metastatic castration resistant prostate cancer (mCRPC). This study aimed to compare TALA+ENZA (TALAPRO-2) to abiraterone acetate plus prednisone (AAP) (COU-AA-302) and docetaxel (TAX 327) using a matching-adjusted indirect treatment comparison (MAIC). A systematic literature review using the Ovid® interface was performed to identify relevant evidence. Patient-level data from TALAPRO-2 and published data from COU-AA-302 and TAX 327 were used to match populations on clinically relevant confounders. The MAICs were conducted for radiographic progression-free survival (rPFS), overall survival (OS), objective response rate (ORR), along with additional efficacy outcomes. In all-comers, TALA+ENZA statistically significantly prolonged rPFS (HR: 0.256; 95% confidence interval [CI]: 0.183, 0.359; <i>p</i> &lt; 0.0001), OS (HR: 0.557; 0.405, 0.766; <i>p</i> = 0.0003), and improved ORR (OR: 3.924; 2.017, 7.634; <i>p</i> = 0001) versus AAP. In all-comers, TALA+ENZA significantly prolonged OS (HR: 0.446; 0.316, 0.631; <i>p</i> &lt; 0.0001) and improved ORR (OR: 13.081; 5.757, 29.721; <i>p</i> &lt; 0.0001) versus docetaxel. All other efficacy outcomes statistically favored TALA+ENZA. These results suggest TALA+ENZA improves clinical outcomes relative to AAP and docetaxel in the 1 L mCRPC all-comers population. Metastatic castration-resistant prostate cancer (mCRPC) is an advanced form of prostate cancer that continues to grow despite treatments that lower testosterone levels. Despite therapeutic advances, the condition remains incurable, contributing to higher mortality and lower quality of life. This study aimed to compare a new treatment (talazoparib plus enzalutamide) with standard treatments (abiraterone acetate and docetaxel) for prostate cancer that has spread and is resistant to standard hormone therapy. Researchers used results from three separate clinical trials to compare these treatments. They looked at the TALAPRO-2 trial for talazoparib plus enzalutamide, the COU-AA-302 trial for abiraterone acetate, and the TAX 327 trial for docetaxel. They adjusted for differences in patient characteristics to ensure a fair comparison. The results suggest that the new treatment (talazoparib plus enzalutamide) is a beneficial therapeutic option for the treatment of men with mCRPC. This study provides important information that could help decision makers make better treatment decisions for patients with advanced prostate cancer. It highlights the potential benefits of the new treatment and supports further research and consideration in clinical practice.