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 "slug": "chemohormonal-therapy",
 "title": "Chemohormonal therapy",
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 "excerpt": "Chemohormonal therapy is a cancer treatment combining chemotherapy with hormonal therapy, principally six cycles of docetaxel added to androgen deprivation therapy, which prolongs survival in metastatic hormone-sensitive prostate cancer.",
 "snippet": "Chemohormonal therapy is a cancer treatment combining chemotherapy with hormonal therapy, principally six cycles of docetaxel added to androgen deprivation therapy, which prolongs survival in metastatic hormone-sensitive prostate cancer.",
 "node": "life.health.medicines.cancer-chemotherapy.hormonal-and-endocrine-therapy",
 "markdown": "# Chemohormonal therapy\n\nChemohormonal therapy is a cancer treatment that combines cytotoxic chemotherapy with hormonal therapy, used principally in metastatic hormone-sensitive prostate cancer, where six cycles of docetaxel are added to androgen deprivation therapy (ADT). In this setting the combination prolongs overall survival: the CHAARTED trial reported a median overall survival of 57.6 versus 47.2 months (hazard ratio for death 0.72),<sup>[1](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)</sup> the [STAMPEDE trial](https://www.edgepedia.org/stampede-trial) reported 81 versus 71 months (HR 0.78),<sup>[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901037-5/fulltext)</sup> and a Cochrane review of three trials in 2,261 men estimated 94 fewer deaths per 1,000 men treated (HR 0.77, 95% CI 0.68–0.87).<sup>[3](https://www.cochrane.org/CD012816/PROSTATE_adding-taxane-based-chemotherapy-androgen-deprivation-therapy-treatment-metastatic-hormone-sensitive)</sup> Standard first-line treatment of metastatic hormone-sensitive prostate cancer is now ADT plus an androgen receptor-targeted therapy, with or without docetaxel in selected patients,<sup>[4](https://www.elsevier.es/en-revista-actas-urologicas-espanolas-english-392-articulo-recommendations-on-treatment-metastatic-hormone-sensitive-S2173578624000684)</sup> so chemohormonal therapy today usually means the docetaxel doublet or one of the docetaxel-containing triplets.\n\n| Key fact | Figure | Source |\n|---|---|---|\n| Standard regimen | Docetaxel 75 mg/m² every 3 weeks for six cycles, started with ADT | <sup>[5](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)</sup> |\n| Overall survival, CHAARTED (long-term) | 57.6 vs 47.2 months; HR 0.72 (95% CI 0.59–0.89) | <sup>[1](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)</sup> |\n| Benefit by disease volume | High-volume HR 0.63; low-volume HR 1.04 (no benefit) | <sup>[1](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)</sup> |\n| Pooled effect (Cochrane) | HR 0.77; 94 fewer deaths per 1,000 men | <sup>[3](https://www.cochrane.org/CD012816/PROSTATE_adding-taxane-based-chemotherapy-androgen-deprivation-therapy-treatment-metastatic-hormone-sensitive)</sup> |\n| Toxicity cost | Grade 3–5 adverse events 52% vs 32% with ADT alone (STAMPEDE) | <sup>[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901037-5/fulltext)</sup> |\n| Triplet over doublet | Darolutamide triplet HR 0.68 vs ADT + docetaxel (ARASENS) | <sup>[6](https://doi.org/10.1056/nejmoa2119115)</sup> |\n| Current restriction | Triplet benefit not confined by disease volume; survival benefit is best established in high-volume disease | <sup>[7](https://www.sciencedirect.com/science/article/pii/S0302283825005093?via%3Dihub=)</sup><sup> • </sup><sup>[26](https://pmc.ncbi.nlm.nih.gov/articles/PMC12091038/)</sup> |\n\n## How it works\n\nDocetaxel is a taxane. It binds β-tubulin, inhibits microtubule depolymerization, arrests the cell cycle in the G2M phase, and inhibits the antiapoptotic protein Bcl-2 through phosphorylation; inhibition of the androgen receptor (AR) and its downstream genes has more recently emerged as an additional mechanism.<sup>[8](https://journals.lww.com/indianjurol/fulltext/2016/32040/role_of_systemic_chemotherapy_in_metastatic.3.aspx)</sup> [Taxanes](https://www.edgepedia.org/taxanes) thereby prevent cell division and promote cell death.<sup>[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC10417637/)</sup>\n\nThe rationale for giving chemotherapy together with ADT rather than sequentially rests on three arguments. First, castration-resistant cells are thought to be present at diagnosis, so targeting both castration-sensitive and castration-resistant clones upfront is beneficial.<sup>[10](https://www.tandfonline.com/doi/pdf/10.1586/14737140.2015.1074042)</sup> Second, the cytotoxic effect of chemotherapy may enhance ADT-mediated apoptosis, producing synergistic cell kill, and chemotherapy may be better tolerated earlier in the disease course.<sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC9774055/)</sup> Third, castration itself changes docetaxel handling: docetaxel clearance was increased by 100% in castrated compared with non-castrated men in one pharmacokinetic analysis.<sup>[12](https://link.springer.com/article/10.1186/s12916-015-0543-9)</sup> The combination matters because ADT alone eventually fails in essentially all patients, with median sensitivity to ADT lasting 24 to 36 months before castration-resistant progression.<sup>[8](https://journals.lww.com/indianjurol/fulltext/2016/32040/role_of_systemic_chemotherapy_in_metastatic.3.aspx)</sup>\n\n## How it is done\n\nThe reference regimen is docetaxel 75 mg/m² intravenously every 3 weeks for six cycles, started together with ADT, with premedication of 8 mg oral dexamethasone at 12, 3, and 1 hours before each infusion; daily prednisone was not required in CHAARTED.<sup>[5](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)</sup> The NICE guideline committee recommends six 3-weekly cycles at 75 mg/m², with or without daily prednisolone.<sup>[13](https://www.ncbi.nlm.nih.gov/books/NBK576975/)</sup> STAMPEDE used the same docetaxel schedule with prednisolone 10 mg daily.<sup>[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901037-5/fulltext)</sup> The Cochrane review defined the intervention as taxane chemotherapy started within 120 days of beginning ADT.<sup>[3](https://www.cochrane.org/CD012816/PROSTATE_adding-taxane-based-chemotherapy-androgen-deprivation-therapy-treatment-metastatic-hormone-sensitive)</sup> In the triplet regimens, per the ARASENS protocol, docetaxel should begin within 6 weeks of the first darolutamide dose, with darolutamide 600 mg (two 300 mg tablets) orally twice daily with food, a total of 1,200 mg per day.<sup>[14](https://ascopubs.org/doi/10.1200/JCO.23.00155)</sup>\n\n## Origin\n\nADT has been the backbone of metastatic prostate cancer treatment since the first description of the disease's hormonal dependence in 1941; docetaxel became the mainstay for castration-resistant disease after SWOG 9916 and TAX 327 established three-weekly docetaxel as first-line chemotherapy after hormonal failure, and it received FDA approval in 2004.<sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC9774055/)</sup>\n\nThe first phase III test of the combination in hormone-naive metastatic disease was the GETUG-AFU 15 trial, reported by Gwenaelle Gravis and colleagues in 2013 in The Lancet Oncology; it began accruing in 2004.<sup>[15](https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2812%2970560-0/abstract)</sup> It enrolled 385 patients and found no survival benefit (median overall survival 58.9 vs 54.2 months; HR 1.01, 95% CI 0.75–1.36), concluding that docetaxel should not be used first-line in non-castrate metastatic disease.<sup>[15](https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2812%2970560-0/abstract)</sup> Explanations offered for this result include its much higher use of salvage docetaxel in the control arm (45.2% vs 22.5% in CHAARTED), which made it more a comparison of early versus late docetaxel.<sup>[8](https://journals.lww.com/indianjurol/fulltext/2016/32040/role_of_systemic_chemotherapy_in_metastatic.3.aspx)</sup>\n\nThe first trial to show a survival benefit was CHAARTED (E3805), reported by [Christopher J. Sweeney](https://www.edgepedia.org/christopher-j-sweeney) and colleagues in 2015 in the New England Journal of Medicine.<sup>[5](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)</sup> It randomized 790 men and, at a median follow-up of 28.9 months, showed a median overall survival 13.6 months longer with the combination (57.6 vs 44.0 months; HR 0.61, 95% CI 0.47–0.80).<sup>[5](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)</sup> STAMPEDE, reported by Nicholas D. James and colleagues in 2015 in [The Lancet](https://www.edgepedia.org/the-lancet), confirmed the benefit in 2,962 men randomized to standard of care alone or with docetaxel, zoledronic acid, or both (median overall survival 81 vs 71 months; HR 0.78, 95% CI 0.66–0.93); zoledronic acid showed no survival benefit.<sup>[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901037-5/fulltext)</sup>\n\n## Variants\n\nThe docetaxel doublet can be stacked with an androgen receptor pathway inhibitor (ARPI). In the ARASENS trial, reported by [Matthew R. Smith](https://www.edgepedia.org/matthew-r-smith) and colleagues in 2022 in the New England Journal of Medicine, adding darolutamide to ADT plus docetaxel improved overall survival (HR 0.68, 95% CI 0.57–0.80; median overall survival not reached vs 48.9 months at median follow-up 43.7 months; 4-year overall survival 62.7% vs 50.4%).<sup>[6](https://doi.org/10.1056/nejmoa2119115)</sup><sup> • </sup><sup>[16](https://www.auanet.org/documents/practices-resources/Combination%20Therapy%20for%20Prostate%20Cancer%20Resource.pdf)</sup> In PEACE-1, reported by [Karim Fizazi](https://www.edgepedia.org/karim-fizazi) and colleagues in 2022 in The Lancet, adding abiraterone plus prednisone to ADT plus docetaxel gave an overall survival HR of 0.75 (95% CI 0.59–0.95) and raised median radiographic progression-free survival to 4.46 versus 2.03 years.<sup>[17](https://doi.org/10.1016/s0140-6736%2822%2900367-1)</sup><sup> • </sup><sup>[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC10417637/)</sup> PEACE-1 improved overall survival in high-volume but not low-volume metastatic disease, while radiographic progression-free survival improved in both.<sup>[18](https://www.frontiersin.org/journals/oncology-reviews/articles/10.3389/or.2025.1599292/full)</sup> In ENZAMET, reported by Andrew J. Armstrong and colleagues in the Journal of Clinical Oncology, enzalutamide with ADT (with permitted docetaxel) gave an overall survival HR of 0.70 (95% CI 0.58–0.84) in the overall randomized population, while the HR was 0.82 (95% CI 0.63–1.06) in the subgroup receiving planned concurrent docetaxel.<sup>[19](https://doi.org/10.1200/jco.22.00193)</sup><sup> • </sup><sup>[20](https://jamanetwork.com/journals/jamaoncology/fullarticle/2818568)</sup> A darolutamide plus ADT doublet without docetaxel has also been tested in metastatic hormone-sensitive disease in the ARANOTE trial, reported by [Fred Saad](https://www.edgepedia.org/fred-saad) and colleagues in 2024 in the Journal of Clinical Oncology.<sup>[21](https://doi.org/10.1200/jco-24-01798)</sup> No direct randomized comparison of triplet therapy with the ADT plus ARPI doublet exists.<sup>[18](https://www.frontiersin.org/journals/oncology-reviews/articles/10.3389/or.2025.1599292/full)</sup>\n\n## Applications\n\nCHAARTED defined high-volume disease as visceral metastases or four or more bone lesions with at least one beyond the vertebral bodies and pelvis, and stratified patients prospectively.<sup>[5](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)</sup> In its long-term analysis (median follow-up 53.7 months), median overall survival was 57.6 versus 47.2 months overall (HR 0.72, 95% CI 0.59–0.89). In high-volume disease (\\( n = 513 \\)) it was 51.2 versus 34.4 months (HR 0.63, 95% CI 0.50–0.79); in low-volume disease (\\( n = 277 \\)) no benefit was observed (HR 1.04, 95% CI 0.70–1.55), and the treatment-by-volume interaction was significant (\\( P = .033 \\)).<sup>[1](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)</sup> Median time to castration-resistant disease was 19.4 versus 11.7 months overall.<sup>[1](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)</sup>\n\nSTAMPEDE showed the same pattern: an overall survival benefit in M1 patients (65 vs 43 months; HR 0.73, 95% CI 0.59–0.89) but not in M0 disease (HR 1.01).<sup>[8](https://journals.lww.com/indianjurol/fulltext/2016/32040/role_of_systemic_chemotherapy_in_metastatic.3.aspx)</sup> Pooled estimates agree: the Cochrane review found progression reduced with an HR of 0.63,<sup>[3](https://www.cochrane.org/CD012816/PROSTATE_adding-taxane-based-chemotherapy-androgen-deprivation-therapy-treatment-metastatic-hormone-sensitive)</sup> and a meta-analysis of six randomized trials (\\( n = 2{,}675 \\)) found HR 0.75 for overall survival and 0.64 for clinical progression-free survival; estramustine-based chemotherapy plus ADT did not improve survival.<sup>[22](https://www.sciencedirect.com/science/article/abs/pii/S1078143916000855)</sup> A 2023 expert consensus recommends triplet therapy for fit patients with aggressive disease, excluding metachronous or low-volume disease and chemotherapy contraindications.<sup>[23](https://www.ovid.com/jnls/ursc/fulltext/10.1097/us9.0000000000000038~2023-expert-consensus-on-decision-pathway-of-metastatic)</sup>\n\n## Limitations and alternatives\n\nThe toxicity cost is substantial. In STAMPEDE, grade 3–5 adverse events were reported for 52% of patients on standard of care plus docetaxel versus 32% on standard of care alone.<sup>[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901037-5/fulltext)</sup> In CHAARTED, grade 3/4 febrile neutropenia occurred in 6.2%, grade 3/4 infection with neutropenia in 2.3%, and grade 3 sensory and motor neuropathy in 0.5% each; about 86% of the 390 combination patients who started therapy completed six cycles.<sup>[5](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)</sup> The Cochrane review found grade III–V adverse events increased nearly threefold (RR 2.98) and a large increase in treatment discontinuation due to adverse events, while quality of life at 12 months showed only a small, possibly unimportant improvement.<sup>[3](https://www.cochrane.org/CD012816/PROSTATE_adding-taxane-based-chemotherapy-androgen-deprivation-therapy-treatment-metastatic-hormone-sensitive)</sup> Real-world results are worse than trial results: the early-docetaxel trials enrolled generally younger patients (median age under 65) with excellent performance status, leaving the treatment of older, less fit patients unresolved,<sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC9774055/)</sup> and a Princess Margaret Cancer Centre study found 9.6% febrile neutropenia on three-weekly docetaxel (versus 3% in TAX 327) and a median overall survival of 13.6 versus 19.3 months, suggesting trial benefits are exaggerated in routine practice.<sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC9774055/)</sup>\n\nThe survival benefit of the docetaxel doublet is concentrated in high-volume disease and absent in low-volume disease,<sup>[1](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)</sup> and ASCO states that docetaxel plus ADT should not be offered to low-volume patients who are chemotherapy candidates because of insufficient evidence.<sup>[14](https://ascopubs.org/doi/10.1200/JCO.23.00155)</sup> Frail and elderly patients were underrepresented in trials; a PEACE-1 subanalysis suggested patients aged 70 or older derive less benefit, possibly because toxicity leads to drug discontinuation.<sup>[4](https://www.elsevier.es/en-revista-actas-urologicas-espanolas-english-392-articulo-recommendations-on-treatment-metastatic-hormone-sensitive-S2173578624000684)</sup> Underdelivery is common: insurance claims data indicate more than one third of US patients with metastatic hormone-sensitive disease are initially treated with ADT alone, and physicians reported in a 2018–2022 survey that only 30.3% of patients received combination therapy first-line.<sup>[16](https://www.auanet.org/documents/practices-resources/Combination%20Therapy%20for%20Prostate%20Cancer%20Resource.pdf)</sup> In ENZAMET, patients with synchronous low-volume disease receiving concurrent docetaxel had worse PSA progression and prostate-cancer-specific survival than those not receiving docetaxel.<sup>[7](https://www.sciencedirect.com/science/article/pii/S0302283825005093?via%3Dihub=)</sup>\n\nGuidelines have moved since 2023. Darolutamide plus docetaxel plus ADT was FDA-approved on August 5, 2022 for metastatic hormone-sensitive prostate cancer,<sup>[14](https://ascopubs.org/doi/10.1200/JCO.23.00155)</sup> and the EAU Prostate Cancer Guidelines, updated in 2026, no longer recommend docetaxel as the sole addition to ADT when an ARPI is available, and recommend discussing the choice between a triplet and the ADT-ARPI doublet with de novo and/or high-volume/high-risk patients.<sup>[24](https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1462360/full)</sup> NCCN guidelines call for first-line ADT plus an ARPI, with docetaxel added as triplet therapy, and advise against monotherapy except in significant frailty.<sup>[16](https://www.auanet.org/documents/practices-resources/Combination%20Therapy%20for%20Prostate%20Cancer%20Resource.pdf)</sup> A living network meta-analysis of 11 phase 3 trials (12,668 patients) favored triplet therapy in fit patients with synchronous high-volume disease, and ADT plus an ARPI in all other subgroups, with no added value from docetaxel.<sup>[7](https://www.sciencedirect.com/science/article/pii/S0302283825005093?via%3Dihub=)</sup> An updated network meta-analysis of 23 trials (\\( n = 18{,}689 \\)) found no triplet regimen showed a statistically significant overall survival benefit over ARPI plus ADT in the all-comer population, but docetaxel triplets improved survival in the high-volume subgroup (HR 0.76, 95% CI 0.61–0.95, high certainty), an estimated 3.2% increase in 3-year overall survival; severe adverse event estimates for the triplet were imprecise.<sup>[25](https://www.auajournals.org/doi/10.1097/JU.0000000000005131)</sup> The AMPLITUDE, PSMAddition, and CAPItello-281 trials have introduced PARP inhibitors, PSMA-directed theranostic therapies, and AKT inhibitors into further intensification of first-line treatment.<sup>[25](https://www.auajournals.org/doi/10.1097/JU.0000000000005131)</sup> For high-risk non-metastatic disease, docetaxel showed no overall survival difference, warranting shared decision-making.<sup>[13](https://www.ncbi.nlm.nih.gov/books/NBK576975/)</sup>\n\n## References\n\n1. [Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial (JCO 2018)](https://ascopubs.org/doi/10.1200/JCO.2017.75.3657)\n2. [STAMPEDE: addition of docetaxel, zoledronic acid, or both to first-line hormone therapy (Lancet 2015)](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901037-5/fulltext)\n3. [Adding taxane-based chemotherapy to androgen deprivation therapy for the treatment of metastatic hormone-sensitive prostate cancer (Cochrane review, 2018)](https://www.cochrane.org/CD012816/PROSTATE_adding-taxane-based-chemotherapy-androgen-deprivation-therapy-treatment-metastatic-hormone-sensitive)\n4. [Recommendations on the treatment of metastatic hormone-sensitive prostate cancer: Patient selection (Actas Urológicas Españolas)](https://www.elsevier.es/en-revista-actas-urologicas-espanolas-english-392-articulo-recommendations-on-treatment-metastatic-hormone-sensitive-S2173578624000684)\n5. [Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer (CHAARTED / E3805)](https://www.nejm.org/doi/full/10.1056/NEJMoa1503747)\n6. [Matthew R. Smith and colleagues (2022). Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa2119115)\n7. [Living Network Meta-analysis of mHSPC by disease volume and timing of metastasis (European Urology, 2025)](https://www.sciencedirect.com/science/article/pii/S0302283825005093?via%3Dihub=)\n8. [Role of systemic chemotherapy in metastatic hormone-sensitive prostate cancer (Indian Journal of Urology 2016)](https://journals.lww.com/indianjurol/fulltext/2016/32040/role_of_systemic_chemotherapy_in_metastatic.3.aspx)\n9. [Current Trends in Chemotherapy in the Treatment of Metastatic Prostate Cancer](https://pmc.ncbi.nlm.nih.gov/articles/PMC10417637/)\n10. [Should docetaxel be administered earlier in prostate cancer therapy? (Expert Review, 2015)](https://www.tandfonline.com/doi/pdf/10.1586/14737140.2015.1074042)\n11. [Early use of chemotherapy in metastatic prostate cancer (review)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9774055/)\n12. [Irrefutable evidence for the use of docetaxel in newly diagnosed metastatic prostate cancer: results from the STAMPEDE and CHAARTED trials (BMC Medicine 2015)](https://link.springer.com/article/10.1186/s12916-015-0543-9)\n13. [Evidence review for docetaxel in people with hormone-sensitive prostate cancer (NICE guideline evidence review)](https://www.ncbi.nlm.nih.gov/books/NBK576975/)\n14. [Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update](https://ascopubs.org/doi/10.1200/JCO.23.00155)\n15. [abstract (thelancet.com)](https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2812%2970560-0/abstract)\n16. [Optimizing First-Line Management of Metastatic Hormone-Sensitive Prostate Cancer (AUA practice resource)](https://www.auanet.org/documents/practices-resources/Combination%20Therapy%20for%20Prostate%20Cancer%20Resource.pdf)\n17. [Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design (The Lancet, 2022)](https://doi.org/10.1016/s0140-6736%2822%2900367-1)\n18. [Triplet systemic therapy for hormone-sensitive prostate cancer: a critical review with a multidisciplinary approach (Frontiers in Oncology Reviews, 2025)](https://www.frontiersin.org/journals/oncology-reviews/articles/10.3389/or.2025.1599292/full)\n19. [Andrew J. Armstrong and colleagues (2022). Improved Survival With Enzalutamide in Patients With Metastatic Hormone-Sensitive Prostate Cancer. Journal of Clinical Oncology.](https://doi.org/10.1200/jco.22.00193)\n20. [Metastatic Hormone-Sensitive Prostate Cancer and Combination Treatment Outcomes: A Review (JAMA Oncology)](https://jamanetwork.com/journals/jamaoncology/fullarticle/2818568)\n21. [Fred Saad and colleagues (2024). Darolutamide in Combination With Androgen-Deprivation Therapy in Patients With Metastatic Hormone-Sensitive Prostate Cancer From the Phase III ARANOTE Trial. Journal of Clinical Oncology.](https://doi.org/10.1200/jco-24-01798)\n22. [Androgen-deprivation therapy plus chemotherapy in metastatic hormone-sensitive prostate cancer: a systematic review and meta-analysis of randomized clinical trials (Clinical Genitourinary Cancer)](https://www.sciencedirect.com/science/article/abs/pii/S1078143916000855)\n23. [2023 expert consensus on decision pathway of metastatic hormone-sensitive prostate cancer (Urological Science)](https://www.ovid.com/jnls/ursc/fulltext/10.1097/us9.0000000000000038~2023-expert-consensus-on-decision-pathway-of-metastatic)\n24. [Sequential versus concomitant treatment of androgen receptor signaling inhibitors and docetaxel for mHSPC: a network meta-analysis (Frontiers in Pharmacology, 2024)](https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1462360/full)\n25. [First-Line Systemic Treatments of mHSPC: Updated Systematic Review and Network Meta-Analysis (Journal of Urology, 2026)](https://www.auajournals.org/doi/10.1097/JU.0000000000005131)\n26. [pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC12091038/)\n\n---\n*Topic: Encyclopedia › Life and health › Human health and medicine › Medicines and therapeutics › Cancer chemotherapy and regimens › Hormonal and endocrine therapy*\n\n*Initially written Sep 29, 2026 · Edited: Oct 15, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n",
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 "credit": "\"Chemohormonal therapy\", Edgepedia (EdgeChat), https://www.edgepedia.org/chemohormonal-therapy. Edgepedia Community License 1.0.",
 "credit_md": "\"[Chemohormonal therapy](https://www.edgepedia.org/chemohormonal-therapy)\", Edgepedia (EdgeChat), [https://www.edgepedia.org/chemohormonal-therapy](https://www.edgepedia.org/chemohormonal-therapy). [Edgepedia Community License 1.0](https://www.edgepedia.org/edgepedia/license).",
 "credit_html": "\"<a href=\"https://www.edgepedia.org/chemohormonal-therapy\">Chemohormonal therapy</a>\", Edgepedia (EdgeChat), <a href=\"https://www.edgepedia.org/chemohormonal-therapy\">https://www.edgepedia.org/chemohormonal-therapy</a>. <a href=\"https://www.edgepedia.org/edgepedia/license\">Edgepedia Community License 1.0</a>.",
 "speakable": "Chemohormonal therapy is a cancer treatment combining chemotherapy with hormonal therapy, principally six cycles of docetaxel added to androgen deprivation therapy, which prolongs survival in metastatic hormone-sensitive prostate cancer."
}