{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:54:42Z","timestamp":1790362482168,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evidence on upfront androgen receptor signaling inhibitor (ARSI) plus androgen deprivation therapy (ADT) in the older population with metastatic castration\u2010sensitive prostate cancer (mCSPC) is scarce. We aimed to compare the oncological outcomes of ARSI plus ADT (upfront doublet therapy) and conventional ADT in mCSPC patients aged \u2265\u200975\u2009years in a real\u2010world clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Subjects were mCSPC patients aged \u2265\u200975\u2009years who received upfront doublet therapy (upfront doublet group) or ADT, either alone or in combination with bicalutamide (conventional ADT group) as a first\u2010line systemic therapy. Castration\u2010resistant prostate cancer\u2010free survival (CRPC\u2010FS), overall survival (OS), and cancer\u2010specific survival (CSS) were analyzed. Propensity score matching (PSM) was used to adjust the clinicopathological features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After PSM, a total of 200 mCSPC patients, 100 in the upfront doublet group and 100 in the conventional ADT group, were included. In the PSM population, median CRPC\u2010FS was 30.8\u2009months in the upfront doublet group and 12.1\u2009months in the conventional ADT group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Median OS was N.A. in the upfront doublet group and 45.2\u2009months in the conventional ADT group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Median CSS was also statistically different between the two groups (N.A. vs. 61.6\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In subgroup analyses, the upfront doublet group showed improved oncological outcomes in high\u2010volume disease compared with the conventional ADT group, but not in low\u2010volume disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The oncological benefits of upfront doublet therapy are not diminished in mCSPC patients, even in the older population; but these benefits are limited when restricted to low\u2010volume disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70202","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:54:44Z","timestamp":1755226484000},"page":"1650-1659","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of Oncological Outcomes of Conventional Androgen Deprivation Therapy (\n                    <scp>ADT<\/scp>\n                    ) and\n                    <scp>ADT<\/scp>\n                    Plus Androgen Receptor Signaling Inhibitor in Older Patients With Metastatic Castration\u2010Sensitive Prostate Cancer"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7555-6295","authenticated-orcid":false,"given":"Yutaka","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Urology Kindai University Nara Hospital  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saizo","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4137-942X","authenticated-orcid":false,"given":"Mamoru","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6934-3760","authenticated-orcid":false,"given":"Takafumi","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Urology Kindai University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1044-912X","authenticated-orcid":false,"given":"Wataru","family":"Fukuokaya","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7410-0712","authenticated-orcid":false,"given":"Takafumi","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University Hospital  Tokyo 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Tsujino","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1563-4888","authenticated-orcid":false,"given":"Yosuke","family":"Hirasawa","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Medical University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1157-4101","authenticated-orcid":false,"given":"Takeshi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Tokyo Medical University Hospital  Tokyo 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