TY - JOUR
T1 - Prostate Cancer Foundation White Paper on Combination Therapy for Metastatic Hormone-Sensitive Prostate Cancer
AU - Carlsson, Sigrid V.
AU - Barata, Pedro C.
AU - Bryce, Alan H.
AU - George, Daniel J.
AU - Gillessen, Silke
AU - Loeb, Stacy
AU - Montgomery, Bruce
AU - Morris, David
AU - Riaz, Irbaz Bin
AU - Palapattu, Ganesh
AU - Schoen, Martin W.
AU - Washington, Samuel L.
AU - Cornell, Brad
AU - Levine, Rebecca
AU - Aggarwal, Pankaj
AU - McGowan, Tracy
AU - Cotter, Matthew
AU - Thompson, Betty
AU - Devgan, Geeta
AU - Russell, David
AU - Kuperman, Gaston
AU - Lenero, Enrique
AU - Iwata, Kenneth
AU - Miyahira, Andrea K.
AU - Soule, Howard R.
AU - Carithers, Gina
AU - Oh, William K.
AU - Agarwal, Neeraj
N1 - Publisher Copyright:
© 2025 American Society of Clinical Oncology
PY - 2025/9
Y1 - 2025/9
N2 - 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—androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI)—or three agents—ADT + ARPI + docetaxel—demonstrate 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.
AB - 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—androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI)—or three agents—ADT + ARPI + docetaxel—demonstrate 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.
UR - https://www.scopus.com/pages/publications/105005715853
U2 - 10.1200/OP-25-00050
DO - 10.1200/OP-25-00050
M3 - Article
C2 - 40315399
AN - SCOPUS:105005715853
SN - 2688-1527
VL - 21
SP - 1240
EP - 1246
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 9
ER -