{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:08:32Z","timestamp":1792004912117,"version":"4.4.0"},"reference-count":52,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Despite several randomized controlled trials demonstrating the benefits of combination therapies for metastatic hormone-sensitive prostate cancer (mHSPC), a significant treatment gap persists. This initiative by the Prostate Cancer Foundation (PCF) convened stakeholders from academia, community practices, industry, and patient advocacy groups to address critical challenges in mHSPC care. Expert discussions and a review of real-world evidence and meta-analyses informed the development of strategies to improve care delivery. Evaluation of the data from global registries, such as IRONMAN, and large community databases was used to assess treatment utilization patterns and disparities. Combination therapies with two agents\u2014androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI)\u2014or three agents\u2014ADT + ARPI + docetaxel\u2014demonstrate significant survival improvements while preserving quality of life for patients with mHSPC, yet adoption remains inconsistent. Of the eligible patients, 20%-60% remain undertreated, with geographic, financial, and systemic barriers contributing to inconsistencies in care. Younger, White, urban-dwelling patients with fewer comorbidities are more likely to receive combination treatment, highlighting disparities across populations. Meta-analyses identified a lack of standardization due to varying inclusion criteria and comparators across trials. Real-world evidence underscored disparities influenced by geographic location, practice type, and access to specialty care. Initiatives such as the PANTHER study highlight improved outcomes in Black patients treated with combination therapies, emphasizing the importance of including diverse populations in clinical trials. To bridge gaps in care, this initiative prioritizes awareness, standardization, and equitable access to evidence-based therapies. Proposed solutions include targeted knowledge dissemination strategies, development of educational resources, and advocacy for policy changes to promote guideline-concordant care. By leveraging collaborative efforts, organizations, including PCF, can contribute to enhancing survival outcomes and quality of life for all patients with mHSPC.<\/jats:p>","DOI":"10.1200\/op-25-00050","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T15:59:20Z","timestamp":1746201560000},"page":"1240-1246","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":7,"title":["Prostate Cancer Foundation White Paper on Combination Therapy for Metastatic Hormone-Sensitive Prostate Cancer"],"prefix":"10.1200","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3553-5710","authenticated-orcid":true,"given":"Sigrid V.","family":"Carlsson","sequence":"first","affiliation":[{"name":"Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Translational Medicine, Division of Urological Cancers, Medical Faculty, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8890-2951","authenticated-orcid":true,"given":"Pedro C.","family":"Barata","sequence":"additional","affiliation":[{"name":"University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0206-3895","authenticated-orcid":true,"given":"Alan H.","family":"Bryce","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Goodyear, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1499-7203","authenticated-orcid":true,"given":"Daniel J.","family":"George","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University Medical Center, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5746-6555","authenticated-orcid":true,"given":"Silke","family":"Gillessen","sequence":"additional","affiliation":[{"name":"Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland"},{"name":"Universit\u00e0 della Svizzera Italia, Faculty of Biosciences, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3933-9207","authenticated-orcid":true,"given":"Stacy","family":"Loeb","sequence":"additional","affiliation":[{"name":"Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington School of Medicine, Fred Hutchinson Cancer Center, VA Puget Sound, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9054-6899","authenticated-orcid":true,"given":"David","family":"Morris","sequence":"additional","affiliation":[{"name":"Urology Associates, PC, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4249-0311","authenticated-orcid":true,"given":"Irbaz Bin","family":"Riaz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. 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