{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:23:54Z","timestamp":1773419034277,"version":"3.50.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The ARASENS trial demonstrated a significant overall survival (OS) benefit for a triplet regimen in metastatic castration-sensitive prostate cancer (mCSPC). We aimed to determine whether this benefit is synergistic or additive. Using a mathematical model of independent drug action and published data from the ARASENS and ARANOTE, we compared the observed OS of the triplet regimen to a predicted OS curve. Reconstructed individual patient data were compared using a Cox model. The observed OS was statistically superior to the predicted OS (hazard ratio [HR] 0.82, 95% CI 0.68\u20130.99; P\u00a0=\u00a0.047), indicating a clinical benefit ~18% greater than the expected additive effect. To address confounding by subsequent therapies, we analyzed time to initial subsequent anticancer therapy, which showed an even more pronounced greater-than-additive benefit (HR 0.57, 95% CI 0.44\u20130.74; P\u00a0&amp;lt;\u00a0.001). These findings suggest the triplet regimen provides an early therapeutic advantage that exceeds additive expectations, supporting an upfront combination strategy in mCSPC.<\/jats:p>","DOI":"10.1093\/jjco\/hyaf211","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T12:32:26Z","timestamp":1765801946000},"page":"366-368","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating synergistic versus additive effects of the triplet regimen in metastatic castration-sensitive prostate cancer: a modeling analysis"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6294-9815","authenticated-orcid":false,"given":"Shinro","family":"Hata","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi , Yufu, Oita 879-5593 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuntaro","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi , Yufu, Oita 879-5593 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Fujinami","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi , Yufu, Oita 879-5593 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyuki","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi , Yufu, Oita 879-5593 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshitaka","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi , Yufu, Oita 879-5593 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2026031310020788900_ref1","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1001\/jama.294.2.238","article-title":"Androgen deprivation therapy for prostate cancer","volume":"294","author":"Sharifi","year":"2005","journal-title":"JAMA"},{"key":"2026031310020788900_ref2","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1056\/NEJMoa1503747","article-title":"Chemohormonal therapy in metastatic hormone-sensitive prostate cancer","volume":"373","author":"Sweeney","year":"2015","journal-title":"N Engl J Med"},{"key":"2026031310020788900_ref3","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1056\/NEJMoa1704174","article-title":"Abiraterone plus prednisone in metastatic, castration-sensitive prostate 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