Table 1. Comparison of systemic therapies shown to improve overall survival when added to ADT among men with mCSPC.

Characteristic	Docetaxel	Abiraterone	Apalutamide	Enzalutamide
Study	CHAARTED (1)STAMPEDE (2)	LATITUDE (3)STAMPEDE (4)	TITAN (10)	ENZAMET (11)
Population	High-volume metastatic†‡	Metastatic	Metastatic	Metastatic
Duration of treatment	18 weeks	Indefinite, median 33 mo	Indefinite, median >36 mo	Indefinite, median >48 mo
Clinically important toxicities	Febrile neutropenia, alopecia, peripheral neuropathy	Arrhythmias, hypertension, hypokalemia	Fatigue, fractures, hypothyroidism, rash	Cognitive dysfunction, fatigue, seizures, syncope
Corticosteroids	Yes	Yes	No	No
HRQoL	Improved§	Improved (13)	Preserved	To be reported
Incremental cost-effectiveness ratio (14)	$34,723	$295,212¶	To be reported	To be reported

^†, STAMPEDE included patients with not only metastatic disease, but also locally advanced disease, high-risk non-metastatic disease, and high-risk relapse after primary treatment; ^‡, high volume per CHAARTED presence of visceral metastases and/or at least four bone lesions with at least one lesion outside of the vertebral column and/or pelvis; ^§, HRQoL was worse at 3 months, but better at 12 months (15); ^¶, assumes full dose of 1,000 mg branded abiraterone daily. Abiraterone in generic form has been approved by the Food and Drug Administration, and 250 mg with a low-fat meal has been shown to be non-inferior to full dose in metastatic castration-resistant prostate cancer based on PSA response in a small study (16). ADT, androgen deprivation therapy; mCSPC, metastatic castration-sensitive prostate cancer.