This study evaluated the effectiveness of combining androgen-deprivation therapy (ADT) with docetaxel in patients with metastatic, hormone-sensitive prostate cancer. The primary objective was to determine if the median overall survival would be 33.3% longer with the combination therapy compared to ADT alone. A total of 790 patients were randomized, with a median follow-up of 28.9 months. The results showed that the median overall survival was 13.6 months longer with the combination therapy (57.6 months vs. 44.0 months; hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). The median time to biochemical, symptomatic, or radiographic progression was 20.2 months in the combination group compared to 11.7 months in the ADT-alone group (hazard ratio, 0.61; 95% CI, 0.51 to 0.72; P<0.001). The rate of a prostate-specific antigen (PSA) level of less than 0.2 ng per milliliter at 12 months was 27.7% in the combination group versus 16.8% in the ADT-alone group (P<0.001). The combination therapy also showed a lower rate of grade 3 or 4 febrile neutropenia (6.2%), grade 3 or 4 infection with neutropenia (2.3%), and grade 3 sensory or motor neuropathy (0.5%). The study concluded that six cycles of docetaxel at the beginning of ADT for metastatic prostate cancer resulted in significantly longer overall survival compared to ADT alone.This study evaluated the effectiveness of combining androgen-deprivation therapy (ADT) with docetaxel in patients with metastatic, hormone-sensitive prostate cancer. The primary objective was to determine if the median overall survival would be 33.3% longer with the combination therapy compared to ADT alone. A total of 790 patients were randomized, with a median follow-up of 28.9 months. The results showed that the median overall survival was 13.6 months longer with the combination therapy (57.6 months vs. 44.0 months; hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). The median time to biochemical, symptomatic, or radiographic progression was 20.2 months in the combination group compared to 11.7 months in the ADT-alone group (hazard ratio, 0.61; 95% CI, 0.51 to 0.72; P<0.001). The rate of a prostate-specific antigen (PSA) level of less than 0.2 ng per milliliter at 12 months was 27.7% in the combination group versus 16.8% in the ADT-alone group (P<0.001). The combination therapy also showed a lower rate of grade 3 or 4 febrile neutropenia (6.2%), grade 3 or 4 infection with neutropenia (2.3%), and grade 3 sensory or motor neuropathy (0.5%). The study concluded that six cycles of docetaxel at the beginning of ADT for metastatic prostate cancer resulted in significantly longer overall survival compared to ADT alone.