How do you choose between ADT/Abiraterone/Capivasertib vs ADT/ARPI/docetaxel for fit patients with de novo high-volume mHSPC and near-complete PTEN loss?

For the patient described — fit, de novo, high-volume disease and near-complete PTEN loss — I would strongly consider ADT + abiraterone + capivasertib. But I do not think the data justify declaring it categorically superior to an ARPI/docetaxel triplet.

The argument for capivasertib becomes particula...

Based on prospective randomized controlled trials, the only treatment that has proven benefit in this setting is the triplet with ADT/abiraterone and Capivasertib. I like this combination in particular for fit patients because the side effect profile should allow them to continue to maintain their f...