Systemic treatment intensification (TI) with androgen receptor pathway inhibitors (ARPIs) and/or chemotherapy significantly improves overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC).
Age modifies the OS benefit: younger men (<70 years) derive greater survival advantage than older men (≥70 years).
In older men, especially those receiving triplet therapies or with low-volume synchronous disease, OS benefits from TI are less pronounced or absent.
Findings provide critical insights for personalized treatment strategies in older men, emphasizing careful consideration of disease burden and intensity of therapy.
