{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:19:05Z","timestamp":1787941145962,"version":"build-2784847793"},"reference-count":23,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"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":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Currently, there are no large cohort studies comparing the clinical outcomes of triplet therapy with those of androgen receptor pathway inhibitor (ARPI)-based doublet therapy for patients with metastatic castration-sensitive prostate cancer (mCSPC) representing real-world practice. Therefore, the present study aimed to compare whether triplet or doublet therapy is more effective in patients with mCSPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This large-scale retrospective cohort study used TriNetX electronic medical record data from August 2018 to July 2026, enrolling patients with mCSPC categorized as receiving triplet [darolutamide + docetaxel + androgen deprivation therapy (ADT)] or doublet therapy (enzalutamide or apalutamide + ADT). The primary outcome was overall survival (OS), while the secondary outcome was the proportion of patients achieving a PSA level\u00a0\u2264\u00a00.2\u00a0ng\/ml. Propensity score matching (PSM) (1:1) was conducted to adjust for confounding variables between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1841 patients met the eligibility criteria. Following PSM (n\u00a0=\u00a0329), triplet therapy was associated with a statistically significant improvement in OS compared with doublet therapy (hazard ratio: 0.601; 95% confidence interval: 0.420\u20130.862; log-rank P\u00a0=\u00a0.005). The proportions of patients achieving PSA \u22640.2\u00a0ng\/ml were 26.4% vs. 17.0% at 3\u00a0months (P\u00a0=\u00a0.003), 37.4% vs. 27.7% at 6\u00a0months (P\u00a0=\u00a0.008), 43.8% vs. 35.9% at 12\u00a0months (P\u00a0=\u00a0.038), and 50.5% vs. 40.1% at any time (P\u00a0=\u00a0.008) in the triplet and doublet groups, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real-world analysis using the TriNetX database, triplet therapy including darolutamide significantly improved OS and PSA decline compared with ARPI-based doublet therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag145","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:16:23Z","timestamp":1786706183000},"source":"Crossref","is-referenced-by-count":0,"title":["Darolutamide-based triplet therapy versus androgen receptor pathway inhibitor-based doublet therapy for metastatic castration-sensitive prostate cancer: a real-world analysis using the TriNetX database"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3884-8915","authenticated-orcid":false,"given":"Yoichiro","family":"Tohi","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Kitadani","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center, Kagawa University Hospital , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2047-496X","authenticated-orcid":false,"given":"Takuma","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Kani","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iori","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Kohashiguchi","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1045-1978","authenticated-orcid":false,"given":"Hirohito","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Homare","family":"Okazoe","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikiya","family":"Taoka","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiaki","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Faculty of Medicine, Kagawa University , Kagawa , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 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