Optimizing triple therapy in patients with metastatic hormone-sensitive prostate cancer

Actas Urol Esp (Engl Ed). 2024 Dec;48(10):703-717. doi: 10.1016/j.acuroe.2024.10.005. Epub 2024 Oct 30.
[Article in English, Spanish]

Abstract

Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.

Keywords: Androgen antagonists; Antagonistas de andrógenos; Consenso; Consensus; Cáncer de la próstata; Disease management; Docetaxel; Expert testimony; Manejo de la enfermedad; Prostatic neoplasms; Testimonio de experto.

Publication types

  • Review

MeSH terms

  • Androgen Antagonists* / therapeutic use
  • Androgen Receptor Antagonists / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Docetaxel / therapeutic use
  • Humans
  • Male
  • Neoplasm Metastasis
  • Prostatic Neoplasms* / drug therapy
  • Prostatic Neoplasms* / pathology
  • Taxoids / therapeutic use

Substances

  • Androgen Antagonists
  • Docetaxel
  • Taxoids
  • Androgen Receptor Antagonists