Wang L, Paller CJ, Hong H, et al. - The effectiveness and safety of systemic treatments for metastatic castration-sensitive prostate cancer as determined in randomized clinical trials were compared in this study. Researchers searched bibliographic databases (MEDLINE, Embase, and Cochrane Central), regulatory documents (US Food and Drug Administration and European Medicines Agency), and trial registries (ClinicalTrials.gov and European Union clinical trials register) from inception through November 5, 2019. They found seven trials with 7,287 participants that compared six treatments (abiraterone acetate, apalutamide, docetaxel, enzalutamide, standard nonsteroidal antiandrogen, and placebo/no treatment). As add-on treatments to androgen-deprivation therapy, abiraterone acetate and apalutamide may offer the largest overall survival benefits with relatively low serious adverse event risks, as seen in this network meta-analysis. Longer follow-up is required to analyze the overall survival benefits associated with enzalutamide, although enzalutamide may improve radiographic progression-free survival to the greatest extent. Substantially higher serious adverse events were seen with docetaxel, while abiraterone was linked with slightly increased serious adverse events,