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@ARTICLE{Fazekas:301540,
      author       = {T. Fazekas and M. Miszczyk and A. Giesen and T. Kói and F.
                      Zattoni and L. Rodriguez-Sanchez and T. Yanagisawa and A.
                      Matsukawa and T. Szarvas$^*$ and P. Kryst and J. G. Rivas
                      and A. S. Merseburger and M. D. Santis and S. Joniau and A.
                      Briganti and G. Marra and P. Nyirády and G. Gandaglia and
                      S. F. Shariat and P. Rajwa},
      collaboration = {E. P. C. W. Group},
      title        = {{A}ndrogen {R}eceptor {P}athway {I}nhibitor {M}onotherapy
                      in {P}rostate {C}ancer: {S}afety, {O}ncologic {O}utcomes,
                      and {Q}uality of {L}ife-{A} {S}ystematic {R}eview and
                      {M}eta-analysis.},
      journal      = {European urology focus},
      volume       = {nn},
      issn         = {2405-4569},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-01061},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Androgen receptor pathway inhibitors (ARPIs) as monotherapy
                      are studied increasingly across prostate cancer disease
                      states. We aimed to evaluate the safety, oncologic efficacy,
                      and quality of life (QoL) of ARPI monotherapy as compared
                      with ARPI + androgen deprivation therapy (ADT) and ADT
                      alone.PubMed/Medline, Embase, and Cochrane/Central were
                      queried through June 2024 for clinical trials. The primary
                      outcomes were the rates of adverse events (AEs) presented as
                      risk ratios (RRs); the secondary outcomes included efficacy
                      and QoL.We synthesized data from 2015 men, retrieved from 17
                      studies. The incidence of any AEs was similar between
                      patients on ARPIs, ARPI + ADT (RR: 1.01, $95\%$ confidence
                      interval [CI]: 1-1.02, p = 0.08), and ADT (RR: 1.01, $95\%$
                      CI: 0.98-1.04, p = 0.3). The incidence of grade ≥3 AEs was
                      higher in patients on ARPI monotherapy than in those on ADT
                      (RR: 1.18, $95\%$ CI: 1.11-1.24, p < 0.01), driven mainly by
                      fatigue and cardiovascular toxicity. There was no
                      statistically significant difference in grade ≥3 AEs
                      between patients treated with ARPIs and ARPI + ADT (RR:
                      1.07, $95\%$ CI: 0.87-1.3, p = 0.4). ARPI monotherapy led to
                      a lower incidence of hot flushes (RR: 0.4, $95\%$ CI:
                      0.18-0.89, p = 0.03) but higher incidences of breast pain
                      (RR: 6.03, $95\%$ CI: 3.34-10.88, p < 0.01) and gynecomastia
                      (RR: 5.73, $95\%$ CI: 3.79-8.66, p < 0.01) than treatment
                      with ARPI + ADT. ARPIs demonstrated promising oncologic
                      efficacy for patients with biochemical recurrence, while
                      maintaining favorable overall and sexual QoL.ARPI
                      monotherapy results in overall similar toxicities for ARPI +
                      ADT and ADT alone. The specific AE pattern of each
                      combination can serve as a basis to tailor therapy to each
                      patient's needs and wishes.},
      subtyp        = {Review Article},
      keywords     = {Abiraterone (Other) / Androgen deprivation therapy (Other)
                      / Androgens (Other) / Apalutamide (Other) / Darolutamide
                      (Other) / Enzalutamide (Other) / Testosterone (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40404535},
      doi          = {10.1016/j.euf.2025.05.006},
      url          = {https://inrepo02.dkfz.de/record/301540},
}