Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach
This article aims to critically evaluate the evidence for triplet therapy consisting of androgen deprivation therapy (ADT), docetaxel and a second-generation androgen receptor pathway inhibitor ([ARPI]; abiraterone, enzalutamide, darolutamide or apalutamide) in patients with metastatic hormone-sensi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Oncology Reviews |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/or.2025.1599292/full |
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| author | Almudena Zapatero Teresa Alonso-Gordoa Alfredo Rodríguez Antolín Felipe Couñago Felipe Couñago Noelia Sanmamed Mario Domínguez Esteban Marta López Valcárcel Ray Manneh Ángel Borque-Fernando Nuria Sala González Pablo Maroto |
| author_facet | Almudena Zapatero Teresa Alonso-Gordoa Alfredo Rodríguez Antolín Felipe Couñago Felipe Couñago Noelia Sanmamed Mario Domínguez Esteban Marta López Valcárcel Ray Manneh Ángel Borque-Fernando Nuria Sala González Pablo Maroto |
| author_sort | Almudena Zapatero |
| collection | DOAJ |
| description | This article aims to critically evaluate the evidence for triplet therapy consisting of androgen deprivation therapy (ADT), docetaxel and a second-generation androgen receptor pathway inhibitor ([ARPI]; abiraterone, enzalutamide, darolutamide or apalutamide) in patients with metastatic hormone-sensitive prostate cancer (mHSPC), and what this evidence reveals regarding the use of these treatments in clinical practice. A search of PubMed, Medline, Embase, Cochrane, Scopus and Web of Science was conducted in April 2024 to identify relevant prospective and retrospective observational trials, randomized controlled trials (RCTs) and meta-analyses. The search identified 52 relevant articles: six full articles and 31 abstracts based on three RCTs, one observational study and 14 meta-analyses. Abiraterone- or darolutamide-containing triplet therapy was significantly better than ADT + docetaxel for improving overall survival in all study populations, particularly subgroups with high-volume and/or synchronous disease. The tolerability of ADT + docetaxel and triplet therapy were similar with most adverse events related to docetaxel. There were no data comparing triplet therapy with ADT + ARPI doublet therapy. Triplet therapy appears to be the most effective first-line regimen for men with mHSPC, good performance status and high-volume and synchronous metastases. Darolutamide-based triplet therapy may also be of benefit in other patients with high- or low-risk disease. Careful consideration of the risks and benefits are required to determine which patients can be spared from receiving docetaxel and rather be treated with alternative regimens. |
| format | Article |
| id | doaj-art-cfc27a8810ab46388a8cf160cd52aebf |
| institution | Kabale University |
| issn | 1970-5557 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Oncology Reviews |
| spelling | doaj-art-cfc27a8810ab46388a8cf160cd52aebf2025-08-20T03:55:48ZengFrontiers Media S.A.Oncology Reviews1970-55572025-07-011910.3389/or.2025.15992921599292Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approachAlmudena Zapatero0Teresa Alonso-Gordoa1Alfredo Rodríguez Antolín2Felipe Couñago3Felipe Couñago4Noelia Sanmamed5Mario Domínguez Esteban6Marta López Valcárcel7Ray Manneh8Ángel Borque-Fernando9Nuria Sala González10Pablo Maroto11Radiation Oncology Department, Health Research Institute, Hospital Universitario de La Princesa, Madrid, SpainMedical Oncology Department, Ramón y Cajal University Hospital, Madrid, SpainUrology Service, Hospital Universitario 12 de Octubre, Madrid, SpainGenesisCare Radiation Oncology Department, San Francisco de Asís University Hospital and Vithas La Milagrosa University Hospital, Madrid, SpainDepartment of Medicine, Faculty of Medicine, Health and Sport Sciences, Universidad Europea de Madrid, Madrid, SpainRadiation Oncology Department, Clínico San Carlos Hospital, Madrid, SpainUrology Service, Marqués de Valdecilla University Hospital, Santander, SpainRadiation Oncology Department, Puerta de Hierro Majadahonda University Hospital, Madrid, SpainSociety of Oncology and Hematology of Cesar, Valledupar, Colombia0Urology Service, Miguel Servet University Hospital, IIS-Aragón, Zaragoza, Spain1Medical Oncology Service, Catalan Institute of Oncology, Josep Trueta Hospital, Girona, Spain2Medical Oncology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, SpainThis article aims to critically evaluate the evidence for triplet therapy consisting of androgen deprivation therapy (ADT), docetaxel and a second-generation androgen receptor pathway inhibitor ([ARPI]; abiraterone, enzalutamide, darolutamide or apalutamide) in patients with metastatic hormone-sensitive prostate cancer (mHSPC), and what this evidence reveals regarding the use of these treatments in clinical practice. A search of PubMed, Medline, Embase, Cochrane, Scopus and Web of Science was conducted in April 2024 to identify relevant prospective and retrospective observational trials, randomized controlled trials (RCTs) and meta-analyses. The search identified 52 relevant articles: six full articles and 31 abstracts based on three RCTs, one observational study and 14 meta-analyses. Abiraterone- or darolutamide-containing triplet therapy was significantly better than ADT + docetaxel for improving overall survival in all study populations, particularly subgroups with high-volume and/or synchronous disease. The tolerability of ADT + docetaxel and triplet therapy were similar with most adverse events related to docetaxel. There were no data comparing triplet therapy with ADT + ARPI doublet therapy. Triplet therapy appears to be the most effective first-line regimen for men with mHSPC, good performance status and high-volume and synchronous metastases. Darolutamide-based triplet therapy may also be of benefit in other patients with high- or low-risk disease. Careful consideration of the risks and benefits are required to determine which patients can be spared from receiving docetaxel and rather be treated with alternative regimens.https://www.frontiersin.org/articles/10.3389/or.2025.1599292/fullandrogen deprivation therapyandrogen receptor-targeted therapydocetaxelhormone-sensitive prostate cancermetastatic prostate cancer |
| spellingShingle | Almudena Zapatero Teresa Alonso-Gordoa Alfredo Rodríguez Antolín Felipe Couñago Felipe Couñago Noelia Sanmamed Mario Domínguez Esteban Marta López Valcárcel Ray Manneh Ángel Borque-Fernando Nuria Sala González Pablo Maroto Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach Oncology Reviews androgen deprivation therapy androgen receptor-targeted therapy docetaxel hormone-sensitive prostate cancer metastatic prostate cancer |
| title | Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach |
| title_full | Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach |
| title_fullStr | Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach |
| title_full_unstemmed | Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach |
| title_short | Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach |
| title_sort | triplet systemic therapy for hormone sensitive prostate cancer a critical review with a multidisciplinary approach |
| topic | androgen deprivation therapy androgen receptor-targeted therapy docetaxel hormone-sensitive prostate cancer metastatic prostate cancer |
| url | https://www.frontiersin.org/articles/10.3389/or.2025.1599292/full |
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