
A systematic review and network meta‐analysis were performed to compare the efficacy and safety of existing treatments for the management of metastatic hormone‐sensitive prostate cancer (mHSPC), as there has been a paradigm shift with the use of next‐generation androgen receptor inhibitors (ARIs) and docetaxel. Abiraterone (hazard ratio [HR] 0.83), docetaxel (HR 0.90), and enzalutamide (HR 0.85) were associated with significantly better OS than androgen‐deprivation therapy (ADT), and abiraterone emerged as the best option. Abiraterone, apalutamide, docetaxel, and enzalutamide were associated with significantly better PFS than ADT, and enzalutamide emerged as the best option. Abiraterone (HR 0.85, 95% CrI 0.78–0.93), apalutamide (HR 0.87, 95% CrI 0.77–0.98), and enzalutamide (HR 0.80, 95% CrI 0.73–0.88) were significantly more effective than docetaxel.
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