Alicia Morgans, MD, highlights real-world study of triplet regimens for mHSPC

In the following video, Alicia K. Morgans, MD, MPH, discusses findings from the ARAAT study, a real-world analysis evaluating triplet therapy regimens for patients with metastatic hormone-sensitive prostate cancer (mHSPC). The results were presented at the 2026 American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco, California.¹

Morgans is a genitourinary medical oncologist at Dana-Farber Cancer Institute in Boston, Massachusetts.

Morgans explained that the study was designed to better understand how different androgen receptor pathway inhibitors (ARPIs) perform when used as part of triplet therapy with androgen deprivation therapy (ADT) and docetaxel. The ARAAT analysis specifically compared outcomes among patients receiving triplet therapy with either darolutamide (Nubeqa) or abiraterone (Zytiga)—both recommended treatment strategies for mHSPC.

The study included 592 patients with mHSPC who were treated across oncology clinics in the US and initiated triplet therapy during the study period (Jan 2020 to Jan 2025). Among all patients, 368 received darolutamide plus ADT and docetaxel and 224 received abiraterone plus ADT and docetaxel. The median follow-up was 19 months in both treatment arms.

Overall, the study showed that patients receiving darolutamide were more likely to achieve low prostate-specific antigen (PSA) levels and did so more quickly than those treated with abiraterone. The probability of a PSA level less than 0.2 ng/mL after 12 months was 61.6% in the darolutamide ar vs 52.6% in the abiraterone arm. After 24 months, these probabilities were 72% with darolutamide and 59.9% with abiraterone. The time to PSA less than 0.2 ng/mL was also significantly shorter in the darolutamide arm (HR, 1.34).

In addition, the darolutamide cohort demonstrated longer time to treatment discontinuation (HR, 0.63), longer time to subsequent therapy (HR, 0.54), longer time to metastatic castration-resistant prostate cancer or death (HR, 0.73) and an improvement in overall survival (HR, 0.68) compared with patients in the abiraterone cohort.

REFERENCE

1. Morgans AK, Khan N, Ghadessi M, et al. Androgen-receptor pathway inhibitors triplet therapy (ARAAT): Real-world outcomes in metastatic hormone-sensitive prostate cancer. Presented at: 2026 American Society of Clinical Oncology Genitourinary Cancers Symposium. February 26-28, 2026. San Francisco, California. Abstract 82. https://www.asco.org/abstracts-presentations/256439