How to cite: Atiq MO. Doublet vs Triplet Therapy for Newly Diagnosed Metastatic Prostate Cancer. Grand Rounds in Urology.October, 2025. Accessed Oct 2026. https://grandroundsinurology.com/doublet-vs-triplet-therapy-for-newly-diagnosed-metastatic-prostate-cancer/
Summary
Mohammad O. Atiq, MD, FACP, Assistant Professor of Medicine, University of Chicago, Chicago, Illinois, describes how certain factors affect treatment decisions for metastatic hormone-sensitive prostate cancer (mHSPC). He reviews trial data investigating androgen deprivation therapy (ADT) and treatment intensification using androgen receptor pathway inhibitors (ARPIs) or chemotherapy to illustrate how these therapies improve outcomes in patients with mHSPC.
Dr. Atiq discusses triplet therapy with ADT, docetaxel, and an ARPI. He reviews results from trials evaluating darolutamide and abiraterone in this setting and notes consistent survival benefits in chemo-fit patients with high-volume metastatic disease. He states that the benefit appears most pronounced in men with aggressive disease biology. He adds that the choice between doublet and triplet therapy depends on patient fitness, comorbidities, disease burden, and the expected toxicity profile of each agent.
Dr. Atiq highlights that doublet therapy with ADT and an ARPI is the current standard practice for most men with mHSPC. He states that triplet therapy is a reasonable option for patients with high-volume disease who are fit for chemotherapy. He emphasizes the importance of shared decision-making and careful assessment of disease biology, comorbidity, and treatment goals.
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ABOUT THE AUTHOR
Mohammad O. Atiq, MD, FACP, is an Assistant Professor of Medicine at the University of Chicago in Illinois. Dr. Atiq specializes in hematology and oncology. He is a member of the American Association for Cancer Research, the American Society of Clinical Oncology, the American College of Physicians, the American Medical Association, and the Arkansas Medical Society.
