Survival Trend in Individuals With De Novo Metastatic Prostate Cancer After the Introduction of Doublet Therapy

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Abstract
In randomized clinical trials (RCT), the addition of docetaxel or an androgen receptor pathway inhibitor (ARPi) drugs to standard androgen deprivation therapy (ADT), ie, doublet therapy, increased survival in individuals with de novo metastatic castration-sensitive prostate cancer (mCSPC), ie, metastatic disease at diagnosis.1-9 The improvement was most pronounced in patients with high-volume disease.1,10 In the STAMPEDE trial, abiraterone acetate with prednisone improved 5-year overall survival to 60% compared with 41% in the group treated with ADT alone.6 Similarly, in the LATITUDE trial, median overall survival was 53.3 months in men with de novo metastatic high-risk cancer treated with doublet therapy with abiraterone acetate, compared with 36.5 months in the placebo group.7 Novel ARPis such as enzalutamide and apalutamide, when combined with ADT, have also been demonstrated to significantly increase progression-free survival11 and overall survival.8,9

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