Rethinking Comparisons: Novel Strategies for Evaluating Androgen Receptor Inhibitors in Prostate Cancer
Arun Azad, PhD, MBBS, discusses how matching-adjusted indirect comparison (MAIC) methodology enables the comparison of enzalutamide and darolutamide in metastatic hormone-sensitive prostate cancer (mHSPC) treatment, revealing both agents significantly improve outcomes when added to androgen deprivation therapy (ADT), with clinical decision-making guided by efficacy differences in specific populations (docetaxel-naive, disease volume) and distinct safety profiles, particularly darolutamide’s reduced central nervous system (CNS) toxicity vs enzalutamide’s more established long-term data.
EP. 1: Matching-Adjusted Indirect Comparisons in mHSPC
April 11th 2025A panelist discusses how MAIC (Matching-Adjusted Indirect Comparison) methodology addresses the lack of head-to-head clinical trials in metastatic hormone-sensitive prostate cancer (mHSPC) by adjusting for differences in patient characteristics across separate studies to enable more reliable indirect treatment comparisons.
EP. 2: Key Limitations of MAIC Analyses
April 11th 2025A panelist discusses how Matching-Adjusted Indirect Comparison (MAIC) analyses are limited by potential unmeasured confounding factors, small effective sample sizes after matching, and reliance on published aggregate data, which should be carefully considered when interpreting findings as complementary rather than definitive evidence for treatment decisions.
EP. 3: Study Design: Comparing the ARCHES and ARANOTE trials
April 18th 2025A panelist discusses how the ARCHES and ARANOTE trials differ in their fundamental design elements, with ARCHES evaluating enzalutamide plus androgen deprivation therapy (ADT) vs placebo plus ADT in both metastatic and nonmetastatic patients, whereas ARANOTE specifically studied apalutamide plus ADT vs ADT alone in patients with newly diagnosed metastatic hormone-sensitive prostate cancer.
EP. 4: Key Takeaways From an Indirect Comparison of ENZA and DARO in mHSPC
April 18th 2025A panelist discusses how both the ARCHES and ARANOTE trials demonstrated significant improvements in radiographic progression-free survival with their respective novel hormonal therapies (enzalutamide in ARCHES and apalutamide in ARANOTE) when added to androgen deprivation therapy (ADT) for metastatic hormone-sensitive prostate cancer, with consistent benefits observed across key subgroups and generally manageable safety profiles.
