Not all patients will want to take triplet therapy, but those with high-volume prostate cancer who are chemotherapy eligible are usually a good fit, explained Neal D. Shore, MD, FACS.
For patients with metastatic hormone-sensitive prostate cancer, recent research has shown that triplet therapy has a benefit over doublet therapy.
Both the PEACE-1 and ARASENS trials have combined classic testosterone suppression, androgen-deprivation therapy, with an androgen receptor pathway inhibitor and have shown a benefit in progression-free and overall survival in these patients, explained Neal D. Shore, MD, FACS, medical director of the Carolina Urologic Research Center. In PEACE-1, patients received abiraterone acetate with prednisone plus docetaxel, and in ARASENS, patients received darolutamide with docetaxel.1,2
The addition of docetaxel means a multidisciplinary team is important, he added. Many urologists won’t give docetaxel and will send the patient to a medical oncologist. He discussed the benefits of triplet therapy at the American Urological Association annual meeting.
At the Advanced Prostate Cancer Consensus Conference, there were discussions around who benefits from triplet therapies, Shore said. From his own perspective, the patients who are a good fit will be fit for chemotherapy, with good metabolic parameters and no neuropathy issues. But more importantly, patients have to want to take proactive measures.
“There may be some patients who just don't want to deal with the added adverse reaction profile, and I respect that,” he said. But certain patients with visceral metastases, a significant amount of bone disease, who may have symptomatic discomfort, and who have liver metastases are high on Shore’s list to prioritize for triplet therapy.
References
1. Fizazi K, Foulon S, Carles J, et al; PEACE-1 investigators. Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design. Lancet. 2022;399(10336):1695-1707. doi:10.1016/S0140-6736(22)00367-1
2. Smith MR, Hussain M, Saad F, et al; ARASENS trial investigators. Darolutamide and survival in metastatic, hormone-sensitive prostate cancer. N Engl J Med. 2022;386(12):1132-1142. doi:10.1056/NEJMoa2119115
New Insights Into Meth-Associated PAH Care Gaps: Anjali Vaidya, MD, on Closing the Divide
June 4th 2025Research from Anjali Vaidya, MD, FACC, FASE, FACP, Temple University Hospital, reveals critical care gaps for patients with methamphetamine-associated pulmonary arterial hypertension (PAH), emphasizing the need for early diagnosis and integrated support.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Trastuzumab Deruxtecan Plus Pertuzumab Improves PFS vs Standard Care in HER2+ Breast Cancer
June 2nd 2025Trastuzumab deruxtecan plus pertuzumab demonstrated statistically and clinically significant improvement in progression-free survival (PFS) in HER2-positive breast cancer, potentially representing a new standard of care.
Read More