Jack Andrews, Fellowship-Trained Urologic Oncologist and Surgeon-Scientist at the Mayo Clinic, shared on X:
“Prostate cancer paper of the day ARASENS (NEJM, 2022)
Phase 3 RCT: darolutamide + ADT + docetaxel vs placebo + ADT + docetaxel in mHSPC (n=1306)
- OS: HR 0.68 (0.57–0.80) ~32% ↓ risk of death
- Median OS: NR vs 48.9 mo
- Time to CRPC also clearly delayed (HR ~0.36)
- G3–4 AEs similar (~66% vs 64%); toxicity mostly during docetaxel overlap
Takeaway: triplet therapy improves survival vs ADT + doce a cornerstone advanced-disease result.
Caveat: no head-to-head vs ADT + ARPI doublet; selection still matters.
In 2026 clinic: who are you still choosing for doublet vs triplet and where does upfront / early Lu-PSMA fit alongside those systemic backbones?”
You can also read:
Why Prostate Cancer Spreads to Bone: The Biology Behind Bone Metastases
