Managing patients with metastatic hormone-sensitive prostate cancer: a shared-care approach to combination therapy

The treatment landscape for metastatic hormone-sensitive prostate cancer has evolved significantly over the past decade. Androgen deprivation therapy (ADT) was once the first-line standard of care, but the introduction of combination therapies, including ADT with chemotherapy or antiandrogens, has markedly improved overall survival. Multiple studies have demonstrated that doublet therapies offer substantial survival benefits. More recently, triplet therapy--combining ADT with docetaxel and second-generation antiandrogens--has further improved patient outcomes. Selecting the appropriate combination therapy requires balancing efficacy and toxicity, particularly for older patients or those with comorbidities. Optimal management of these patients demands a multidisciplinary approach that integrates expertise from oncologists, urologists, and other specialists. The shared-care model enhances patient outcomes by facilitating collaboration and optimizing individualized treatment plans. Strengthening communication between oncologists and urologists, particularly regarding the implementation of triplet therapies, is critical for improving patient care.