Real-world comparison of androgen receptor pathway ınhibitors versus docetaxel as first-line treatment in metastatic hormone-sensitive prostate cancer

BACKGROUND: Androgen receptor pathway inhibitors (ARPIs) and docetaxel are established first-line treatment options for metastatic hormone-sensitive prostate cancer (mHSPC); however, no randomized head-to-head trials have directly compared these strategies. We aimed to evaluate the efficacy of ARPI versus docetaxel as first-line treatment in patients with mHSPC. METHODS: = 50). The primary endpoints were radiological progression-free survival (rPFS) and overall survival (OS). Survival outcomes were estimated using the Kaplan-Meier method and compared by log-rank test. Prognostic factors were assessed using univariate and multivariate Cox regression analyses. RESULTS: = 0.392), with no significant subgroup differences observed. CONCLUSION: In this real-world cohort, ARPI-based therapy was associated with an improvement in rPFS compared with docetaxel, while OS outcomes remained comparable. In the absence of direct randomized comparisons, these findings may provide supportive real-world evidence for the clinical relevance of ARPI-based therapy as a first-line treatment option for patients with mHSPC.