Lippincott, Williams & Wilkins, Anti-Cancer Drugs, 1(33), p. e43-e51, 2021
DOI: 10.1097/cad.0000000000001168
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Several novel androgen receptor (AR)-inhibitors have been introduced for nonmetastatic castration-resistant prostate cancer (nmCRPC) treatment, with the improvement of survival outcomes which need to be balanced against the risk of adverse events. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating enzalutamide, apalutamide and darolutamide in nmCRPC patients, to assess overall survival (OS), incidence and risk of adverse drug events, adverse-events-related death and adverse-events-related treatment discontinuation. We selected three RCTs (SPARTAN, PROSPER and ARAMIS). New hormonal agents administration resulted in better OS, despite the increased risk of several any grade and grade 3–4 adverse events. In the decision-making process, careful evaluation of expected adverse events, patients’ comorbidities and maintenance of quality of life are mandatory.