{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:57:14Z","timestamp":1782734234697,"version":"3.54.5"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"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":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>With new treatment strategies approved in metastatic hormone-sensitive prostate cancer (mHSPC), heterogeneity across trials hinders the physicians\u2019 choice for first-line treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We conducted a systematic review and network meta-analysis to assess the efficacy of currently approved treatments for mHSPC stratifying patients according to their disease burden (high- vs. low-volume as per CHAARTED criteria) and onset of metastatic disease (synchronous vs. metachronous).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Eleven randomized controlled trials (RCTs) published until October 30, 2024 were included. Treatment regimens were grouped as triplets for combinations of docetaxel, androgen receptor pathway inhibitors (ARPIs) and androgen-deprivation therapy (ADT), separate doublets for docetaxel plus ADT, ARPI plus ADT, or monotherapy for ADT alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measurements and Statistical Analysis<\/jats:title>\n                    <jats:p>Overall survival (OS) and radiographic progression-free survival (rPFS) outcomes were collected. OS as primary endpoint, and rPFS as secondary endpoint, were analyzed separately in high- and low-volume patients. Additional subgroup analyses accounted for timing of metastases categorized as high-volume\/synchronous, high-volume\/metachronous, low-volume\/synchronous, and low-volume\/metachronous disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Synthesis<\/jats:title>\n                    <jats:p>Triplet combinations prolonged significantly OS and rPFS in high-volume disease (P-score 0.99), and high-volume\/synchronous disease (P-score 0.99). ARPI\/ADT doublets performed best in low-volume patients (P-score 0.94), and low-volume\/metachronous (P-score 0.99). In the high-volume\/metachronous population, triplets, and doublets were equally effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results provide collective evidence for treatment selection based on disease volume and timing of metastasis with strongest survival benefits of triplets for high-volume\/synchronous mHSPC patients and of ARPI doublets for low-volume disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf386","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T12:53:20Z","timestamp":1763211200000},"source":"Crossref","is-referenced-by-count":2,"title":["Best therapeutic approach in metastatic hormone-sensitive prostate cancer based on disease volume: a systematic review and network meta-analysis"],"prefix":"10.1093","volume":"31","author":[{"given":"Fabrizio","family":"Di Costanzo","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Universit\u00e0 degli Studi di Napoli Federico II , Naples,","place":["Italy"]},{"name":"Translational and Clinical Research Institute, Newcastle University , Newcastle Upon Tyne,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Mercinelli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, IRCCS San Raffaele Hospital, Comprehensive Cancer Center , Milan,","place":["Italy"]},{"name":"Vita-Salute San Raffaele University , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Signori","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Genoa , Genoa,","place":["Italy"]},{"name":"IRCCS Policlinico San Martino , Genoa,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Messina","sequence":"additional","affiliation":[{"name":"Oncology Unit, A.R.N.A.S. Civico , Palermo,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6921-714X","authenticated-orcid":false,"given":"Vincenza","family":"Conteduca","sequence":"additional","affiliation":[{"name":"Unit of Medical Oncology and Biomolecular Therapy, and CREATE Center for Research and Innovation Medicine, Department of Medical and Surgical Sciences, University of Foggia , Foggia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Dima","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit 2, Santa-Chiara Hospital , Pisa,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Santoni","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Macerata Hospital , 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Elena","family":"Rebuzzi","sequence":"additional","affiliation":[{"name":"Ospedale San Paolo, Medical Oncology , Savona,","place":["Italy"]},{"name":"Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genoa , Genoa,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orazio","family":"Caffo","sequence":"additional","affiliation":[{"name":"Medical Oncology, Santa Chiara Hospital , Trento,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Luigi","family":"Banna","sequence":"additional","affiliation":[{"name":"Portsmouth Hospitals University NHS Trust , Portsmouth,","place":["United Kingdom"]},{"name":"Faculty of Science and Health, School of Pharmacy and Biomedical Sciences, University of Portsmouth , Portsmouth,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"University Oncology Unit, University of Salento Fazzi Hospital , Lecce,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Procopio","sequence":"additional","affiliation":[{"name":"Genito-Urinary Medical Oncology, IRCCS Foundation Istituto Nazionale Tumori , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Montorsi","sequence":"additional","affiliation":[{"name":"Vita-Salute San Raffaele University , Milan,","place":["Italy"]},{"name":"Department of Urology, IRCCS San Raffaele Hospital , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-0494","authenticated-orcid":false,"given":"Alberto","family":"Briganti","sequence":"additional","affiliation":[{"name":"Vita-Salute San Raffaele University , Milan,","place":["Italy"]},{"name":"Department of Urology, IRCCS San Raffaele Hospital , 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