Based on the STAMPEDE trial pooled analysis, which patients with high risk prostate cancer would you add abiraterone for 2 years?

I often use 2 years of Abi/pred (plus ADT) in patients with high-risk localized prostate cancer who have at least two of these features:

• Gleason grade group 4 or 5
• Clinical/radiographic stage T3 or greater
• PSA 40 ng/mL or greater

This is typically done in conjunction with primary radiotherapy.

The main question I struggle with are the following:

STAMPEDE trial: 6-year metastasis-free survival was 82% (95% CI 79–85) in the Abi/Pred group and 69% (66–72) in the control group. A 13% improvement in metastasis-free survival which is a surrogate for overall survival in prostate cancer.

(Conventional imaging, no pelvic nodal radiation, and no FLAME style micro boost). Attard et al., PMID 34953525.

POP-RT trial: 5-year distant metastasis-free survival was higher with whole pelvic radiation vs...

Eligible patients in STAMPEDE trial had prostate cancer that was newly diagnosed and metastatic, node-positive, or high-risk locally advanced (with at least two of the following: a tumor stage of T3 or T4, a Gleason score of 8 to 10, and a PSA level ≥40 ng per milliliter) or disease that was previously treated with radical surgery or radiotherapy and was now relapsing with high-risk features (in men no longer receiving therapy, a PSA level >4 ng per milliliter with a doubling time of <6 months, ...