Clinical Impact of Gleason Pattern 5 on Doublet Versus Triplet Therapy in Metastatic Hormone-Sensitive Prostate Cancer.
Triplet therapy linked to longer castration-resistant prostate cancer-free survival in Gleason pattern 5-positive disease
Clinical Impact of Gleason Pattern 5 on Doublet Versus Triplet Therapy in Metastatic Hormone-Sensitive Prostate Cancer.
Upfront treatment intensification with androgen deprivation therapy (androgen deprivation therapy) plus an androgen receptor pathway inhibitor has become a standard approach for metastatic hormone-sensitive prostate cancer (mHSPC).
The final analytic cohort consisted of 294 patients.
triplet therapy cut risk of progression to castration resistance in this subgroup
In the overlap weighting-adjusted overall cohort, triplet therapy was associated with longer castration-resistant prostate cancer-free survival than doublet therapy (hazard ratio [HR], 0.29; 95% confidence interval [CI], 0.13-0.64; p = 0.002).
A significant interaction was observed for GP5 status (p for interaction = 0.037).
No clear difference in OS was observed at the current follow-up.
Triplet therapy was associated with longer castration-resistant prostate cancer-free survival than apalutamide- or enzalutamide-based doublet therapy in systemic treatment-naïve mHSPC.
This association appeared more evident in patients with GP5-positive disease.
Given the shorter follow-up in the triplet group, limited event numbers in subgroup and PFS2 analyses, and the nonrandomized nature of post-CRPC treatment sequencing, these findings should be interpreted as hypothesis-generating.