Key clinical point: Combination treatment with androgen deprivation therapy (ADT) shows survival benefit in patients with metastatic hormone-sensitive prostate cancer (mHSPC) vs. ADT alone. ADT in combination with radiotherapy (RT) or enzalutamide extends overall survival (OS) in low-volume disease.

Major finding: Compared with ADT monotherapy, significant OS improvement (hazard ratio; 95% confidence interval) was seen with ADT+abiraterone+prednisolone (0.64; 0.56-0.73), ADT+apalutamide (0.67; 0.51-0.89), ADT+docetaxel (0.78; 0.69-0.88), and ADT+enzalutamide (0.53; 0.37-0.75). ADT+RT did not show an improvement in OS vs. ADT alone (0.96; 0.85-1.1) and was inferior to every combined systemic therapy. In low-volume disease, significant OS improvement was observed with ADT+enzalutamide (0.38; 0.21-0.69) and ADT+RT (0.68; 0.54-0.87).

Study details: A network meta-analysis of 10 randomized controlled trials including 11,194 patients with mHSPC.

Disclosures: The study was funded by the National Natural Science Foundation of China and the Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital. The authors declared no conflicts of interest.