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This study explores the impact of docetaxel plus carboplatin (DC) chemotherapy on serum testosterone levels in metastatic docetaxel-resistant prostate cancer (mDRPC) patients. 123 mDRPC patients were categorized into three groups: (1) no previous ART (<jats:italic>n<\/jats:italic>\u2009=\u200965), (2) previous ART with serum free testosterone (FT)\u2009&gt;\u2009detection limit (DL) at baseline (<jats:italic>n<\/jats:italic>\u2009=\u200931), and (3) previous ART with FT\u2009&lt;\u2009DL at baseline (<jats:italic>n<\/jats:italic>\u2009=\u200927). Salvage DC chemotherapy led to significant reductions in FT and total testosterone (TT) levels in groups 1 and 2 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Group 1 saw FT decrease from 0.85 pg\/mL to below the DL (&lt;\u20090.18 pg\/mL) with 54.3% achieving complete reduction (CR); group 2 showed FT decrease from 0.28 pg\/mL to below the DL with 67.7% achieving CR; group 3 had baseline FT values already below the DL with 96.3% maintaining this level. TT reductions to below the DL occurred in all groups. Low FT was an independent predictor for better PFS and for improved OS in groups 1 and 2. Our data indicate that adding carboplatin may improve the therapeutic effects of docetaxel in a castration-dependent setting.<\/jats:p>","DOI":"10.1038\/s41598-025-04667-0","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T09:10:59Z","timestamp":1750410659000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of adding carboplatin to docetaxel chemotherapy on testosterone levels and treatment outcomes in metastatic docetaxel-resistant prostate cancer"],"prefix":"10.1038","volume":"15","author":[{"given":"Hejar","family":"Atalan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Ivanyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Kappler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian H.","family":"Heidel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph W. 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