Sipuleucel-T and androgen receptor-directed therapy for castration-resistant prostate cancer: A meta-analysis

New treatments,such as sipuleucel-t and androgen receptor-(ar-) directed therapies (enzalutamide (enz) and abiraterone acetate (aa)),have emerged and been approved for the management of castration-resistant prostate cancer (crpc). there are still debates over their efficacy and clinical benefits. this meta-analysis aimed to investigate the efficacy and safety of sipuleucel-t and ar-directed therapies in patients with crpc. revman 5.1 was used for pooled analysis and analysis of publication bias. seven studies were included in the meta-analysis,with three studies in sipuleucel-t (totally 737 patients,488 patients in treatment group,and 249 patients in placebo group) and four in ar-directed therapies (totally 5,199 patients,3,015 patients in treatment group,and 2,184 patients in placebo group). treatment with sipuleucel-t significantly improved overall survival in patients with crpc and was not associated with increased risk of adverse event of grade ≥3 (p>0.05). however,treatment with sipuleucel-t did not improve time-to-progression and reduction of prostate-specific antigen (psa) level ≥50% was not significantly different from that with placebo. ar-directed therapies significantly improved overall survival in patients with crpc and improved time-to-progression and reduction of psa level ≥50%. ar-directed therapies did not increase risk of adverse event of grade ≥3 (p>0.05). © 2016 renliang yi et al.