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For patients who progress to mCRPC on ADT+ARSI started in mCSPC setting, do you continue the ARSI if patients have had a mixed response?

1 Answers

Mednet Member

Medical Oncology · Duke University School of Medicine

A "mixed response" can mean many things and the specific circumstances are critical for decision-making here. For example, bone scan flare, or pseudoprogression, with new unconfirmed lesions, is quite common with ADT/ARSI therapy and should not be a reason for treatment discontinuation as per PCWG2/...

Would you extrapolate from EMBARK to use an ARPI other than enzalutamide in high risk biochemically recurrent prostate cancer for a patient with contraindications to enzalutamide?

1 Answers

Mednet Member

Medical Oncology · Duke University School of Medicine

This is a good question and my general answer is no, as no other ARSI has a phase 3 trial in this nmHSPC setting showing similar benefits. PRESTO was a smaller phase 2 trial of ADT/apalutamide but did not measure or report MFS or OS and was underpowered to look at these endpoints. However if a patie...

Urology

Recent Discussions

For patients who progress to mCRPC on ADT+ARSI started in mCSPC setting, do you continue the ARSI if patients have had a mixed response?

Would you extrapolate from EMBARK to use an ARPI other than enzalutamide in high risk biochemically recurrent prostate cancer for a patient with contraindications to enzalutamide?

William Catalona, MD

Ralph Clayman, MD

Glenn Preminger, MD

Kirsten Greene, MD

Manoj Monga, MD

Emily Hacker

Vivian Wong