
The study assessed the effectiveness of systemic therapies in prostate cancer patients with varying performance statuses (PS) in different disease stages. The analysis of 25 trials for systematic review and 18 for meta-analyses revealed that combination systemic treatments improved overall survival (OS) in patients with both good and worse PS. In non-metastatic castration-resistant PCa (nmCRPC), androgen receptor signaling inhibitors (ARSI) provided greater metastasis-free survival (MFS) benefits in patients with good PS. Triplet therapy, including darolutamide with DOC + ADT, showed the highest likelihood of improved OS in metastatic hormone-sensitive PCa (mHSPC), even in patients with worse PS. Overall, novel systemic therapies appeared to benefit the OS of PCa patients regardless of PS.
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