Efficacy and safety of triple or dual therapies for metastatic hormone-sensitive prostate cancer: a systematic review and Bayesian network meta-analysis

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Aim: To compare triple and dual therapies for efficacy and safety in metastatic hormone-sensitive prostate cancer (mHSPC). Methods: A Bayesian network meta-analysis was conducted to indirectly compare overall survival, progression-free survival and adverse events in mHSPC patients with triple and dual therapies. Results: Triple and dual therapies were related to considerably higher overall survival than androgen-deprivation therapy (ADT), and darolutamide + docetaxel + ADT (hazard ratio [HR]: 0.54; 95% CI: 0.39–0.76; P score = 0.89) emerged as the best option. In terms of progression-free survival, abiraterone + prednisolone + docetaxel + ADT (HR: 0.33; 95% CI: 0.19–0.53; P score = 0.92) emerged as the best option. Apalutamide + ADT had the lowest odds of adverse events. Conclusion: Triple therapies were particularly effective in mHSPC patients, but the incidence of adverse events was significantly high.