Docetaxel Provides Oncological Benefits in the Era of New-Generation Androgen Receptor Inhibitors - or Is Three a Crowd?

Clin Genitourin Cancer. 2024 Feb;22(1):56-66. doi: 10.1016/j.clgc.2023.08.002. Epub 2023 Aug 7.

Abstract

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.

Keywords: Doublet therapy; Prostate cancer; Systemic treatment; Triplet therapy; mHSP.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Androgen Antagonists / therapeutic use
  • Androgen Receptor Antagonists / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Docetaxel / therapeutic use
  • Humans
  • Male
  • Prostatic Neoplasms* / pathology
  • Receptors, Androgen

Substances

  • Docetaxel
  • Receptors, Androgen
  • Androgen Antagonists
  • Androgen Receptor Antagonists