In recent years, several systemic therapies have been introduced for metastatic hormone-sensitive prostate cancer, including androgen deprivation therapy (ADT) combined with docetaxel (Doc) and/or new-generation androgen receptor signaling inhibitors (ARSI). Trials evaluating ADT + ARSI have consistently demonstrated an overall survival (OS) benefit for doublet therapy over ADT alone. Similarly, the STOPCaP meta-analysis showed an OS benefit in favor of ADT + Doc versus ADT alone. ARSI, Doc, and ADT have different antitumor mechanisms, thus potentiating the effect of combination therapy. Two randomized trials showed that the addition of ARSI to ADT + Doc improves OS, especially for synchronous high-volume disease. However, the real question about triplet therapy remains unanswered: whether combining Doc with ARSI improves outcomes compared to ADT + ARSI. As there are no head-to-head comparisons, this narrative review aims to summarize the current evidence regarding triplet therapy versus doublet therapy including ADT+ ARSI.
Clinical genitourinary cancer. 2023 Aug 07 [Epub ahead of print]
Noelia Sanmamed, Juan Gómez-Rivas, David Buchser, Miguel Montijano, María Antonia Gómez-Aparicio, Victor Duque-Santana, Lisselott Torres, Thomas Zilli, Piet Ost, Fernando López-Campos, Felipe Couñago
Radiation Oncology Department, Hospital Universitario Clinico San Carlos, Madrid, Spain., Urology Department, Hospital Universitario Clinico San Carlos, Madrid, Spain., Radiation Oncology Department, Hospital Universitario de Cruces, Bilbao, Spain., Radiation Oncology Department, Genesis Care Hospital San Francisco de Asís and Hospital la Milagrosa, Madrid, Spain., Radiation Oncology Department, Hospital Universitario de Toledo, Toledo, OH, Spain., Radiation Oncology Department, Hospital Quiron, Madrid, Spain., Radiation Oncology Department, Southern Institute of Swiss Oncology, Switzerland., Radiation Oncology Department, Ghent University Hospital, Ghent, Spain., Radiation Oncology Department, Hospital Ramón y Cajal, Madrid, Spain. Electronic address: .