A new population-adjusted network analysis has confirmed that a combination of darolutamide, androgen-deprivation therapy (ADT), and docetaxel significantly improves survival for men with metastatic hormone-sensitive prostate cancer (mHSPC). The study, which adjusted for differences in patient populations across multiple clinical trials, found that this triplet therapy consistently outperformed other commonly prescribed treatment regimens.

Traditional analyses assume that patient groups across different studies are similar, but in reality, factors such as age, overall health, and cancer aggressiveness can influence how well a treatment works. To address these discrepancies, researchers applied two advanced statistical methods—multilevel network meta-regression (ML-NMR) and network meta interpolation (NMI). These approaches adjusted for key variables like age, Gleason score, ECOG performance status, and cancer volume, allowing for a more accurate comparison of treatments.

Analyzing data from twelve clinical trials, compared to:

abiraterone + ADT + Docetaxel
abiraterone + ADT
apalutamide + ADT
enzalutamide + ADT

darolutamide in combination with ADT and docetaxel showed superior overall survival outcomes.
The ML-NMR approach, which incorporated more complete patient data, provided particularly strong evidence in favor of the darolutamide triplet, while the NMI method, though supportive, was hampered by incomplete subgroup data in some studies.

The evidence indicates that patients receiving the darolutamide triplet had a significantly lower risk of death compared to those treated with alternative regimens. While twelve studies were included in the analysis, only eight had full subgroup data, further reinforcing the robustness of the ML-NMR findings. These results suggest that darolutamide, when added to standard ADT and docetaxel, should be considered a leading treatment option for mHSPC.