**Docetaxel:** 75 mg/m², intravenous infusion, once every 3 weeks (administered in weeks 1, 4, and 7), for a total of 3 cycles. To prevent allergic reactions and fluid retention, oral dexamethasone 8 mg is administered twice daily on the day before, the day of, and the day after docetaxel infusion.

**Darolutamide:** 600 mg, orally, twice daily, starting from day 1 of treatment and continued until 1 week before surgery. To be taken with food.

**Homoharringtonine:**

1 mg of homoharringtonine diluted in 250 mL of 5% glucose injection, administered intravenously once daily for two consecutive days, repeated every 3 weeks (administered in weeks 1, 4, and 7), for a total of 3 cycles.

**Androgen Deprivation Therapy:** Luteinizing hormone-releasing hormone (LHRH) analogs such as goserelin. The specific dosage is goserelin 3.6 mg, administered as a subcutaneous injection into the anterior abdominal wall once every 28 day

:-**pCR (Pathological Complete Response)** is defined as the absence of morphologically identifiable cancer in the prostatectomy specimen.

- **MRD (Minimal Residual Disease)** is defined as a maximum cross-sectional diameter of residual tumor ≤ 5 mm, and using RCB (Residual Cancer Burden) ≤ 0.25 cm³ (tumor volume ≤ 0.5 cm³ × tumor cellularity ≤ 50%). Tumor volume is calculated by three-dimensional volume estimation based on the largest cross-sectional dimension of the tumor and the number of cross-sections, with adjustment for tumor cellularity.

Pathological response after radical prostatectomy (including positive surgical margins, tumor size, extraprostatic extension, seminal vesicle invasion, and lymph node involvement)

Change in prespecified transcriptomic features measured in paired tumor tissue samples collected before treatment and at radical prostatectomy, assessed using bulk RNA sequencing and/or single-cell or spatial transcriptomic profiling.