PEACE-1: Triplet Therapy Shows Lasting Survival Benefit at Eight Years

After a median follow-up of 7.7 years, the phase 3 PEACE-1 trial confirms a lasting survival benefit from adding abiraterone and prednisone to standard treatment for men diagnosed with metastatic hormone-sensitive prostate cancer.

The trial enrolled 1,173 men and tested the addition of abiraterone, prostate radiotherapy, or both to androgen deprivation therapy (ADT), with or without docetaxel. Across the overall population, abiraterone reduced the hazard of death by 25%.

Among the 710 patients receiving ADT plus docetaxel, adding abiraterone reduced the hazard of death by 32%. Median overall survival increased from 4.4 to 6.2 years, while estimated survival at eight years rose from 27.1% to 40.3%.

In patients with high-volume disease, median survival increased from 3.5 to 4.6 years, and eight-year survival rose from 20% to 38%, an absolute difference of 18 percentage points.

Results also favoured triplet therapy in low-volume disease, with median survival of 7.8 versus 6.2 years. However, the confidence interval in this subgroup included no difference. The interaction analysis found no evidence that treatment effect differed by metastatic volume, but this does not establish equal benefit in both groups.

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