{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:50:39Z","timestamp":1787986239209,"version":"build-2784847793"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although pivotal trials have demonstrated the superiority of triplet therapy over androgen deprivation therapy (ADT)\u2013docetaxel doublet therapy, direct comparisons between triplet and androgen receptor pathway inhibitor (ARPI)\u2013ADT doublet therapy remain lacking in real-world practice. This study evaluated the comparative efficacy and safety of triplet versus ARPI-doublet therapy in patients with metastatic castration-sensitive prostate cancer (mCSPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 837 patients with de novo mCSPC treated between February 2018 and April 2025 were included: 121 received triplet therapy (darolutamide plus docetaxel with ADT), and 716 received ARPI-doublet therapy (abiraterone acetate, enzalutamide, or apalutamide with ADT). The primary endpoint was castration-resistant prostate cancer\u2013free survival (CRPC-FS), and the secondary endpoints were progression-free survival 2 (PFS2) and treatment-related adverse events (TRAEs). Propensity score\u2013based inverse probability of treatment weighting (IPTW) and multiple sensitivity analyses adjusted for baseline imbalances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median follow-up was 24\u00a0months. In the IPTW-adjusted analysis, triplet therapy significantly improved CRPC-FS compared with ARPI-doublet therapy (hazard ratio 0.52, 95% confidence interval 0.39\u20130.68; P\u00a0&amp;lt;\u00a0.001). Subgroup analysis demonstrated consistent benefits in patients with high-volume disease, while no CRPC events occurred in the low-volume subgroup. Sensitivity analyses using propensity score matching and truncated IPTW confirmed the robustness of these findings. Cancer-specific and overall survival were not assessable because of limited follow-up and few events in the triplet cohort. Regarding safety, triplet therapy was associated with higher rates of grade\u00a0\u2265\u00a03 TRAEs (48.8% vs 8.7%), mainly hematologic toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Triplet therapy significantly prolonged CRPC-FS compared with ARPI-doublet therapy in patients with de novo mCSPC, particularly among those with high-volume disease. However, this benefit was accompanied by higher toxicity, underscoring the need to balance efficacy with safety. Longer follow-up is required to determine impacts on PFS2, cancer-specific survival, and overall survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag005","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:40:56Z","timestamp":1767876056000},"page":"620-627","source":"Crossref","is-referenced-by-count":2,"title":["Triplet therapy versus androgen receptor pathway inhibitor\u2013doublet therapy in metastatic castration-sensitive prostate cancer: a real-world multicenter retrospective comparison"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-8183","authenticated-orcid":false,"given":"Fumihiko","family":"Urabe","sequence":"first","affiliation":[{"name":"Department of Urology, The Jikei University School of Medicine , 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461 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