Complete Response to Concurrent Triplet Therapy in Low-Volume Metastatic Hormone-Sensitive Prostate Cancer: A Case Report.

INTRODUCTION

Triplet therapy with androgen deprivation therapy (ADT), an androgen receptor pathway inhibitor, and docetaxel improves survival in metastatic hormone-sensitive prostate cancer (mHSPC), but its role in low-volume disease remains unclear.

CASE PRESENTATION: A 68-year-old man presented with dysuria and a PSA increase to 34.49 ng/mL. Imaging revealed a prostate tumor extending into the bladder, right obturator lymph node metastasis, and a bone lesion. Biopsy showed Gleason score 5 + 5 prostate adenocarcinoma (cT4N1M1b low-volume mHSPC). Concurrent triplet therapy with ADT, darolutamide, and docetaxel was initiated. PSA decreased to 0.1 ng/mL within 2 months, and imaging at 4.5 months demonstrated a radiological complete response. At the latest follow-up (7 months), the PSA remained below 0.03 ng/mL without progression to CRPC.

CONCLUSION

Concurrent triplet therapy may achieve complete response in selected patients with aggressive low-volume mHSPC.