For very high-risk N0 or cN1 prostate cancer getting definitive RT with long-term ADT, what is your default ARPI intensification?
DASL-HiCaP at ESMO 2026 showed an MFS benefit with darolutamide added to ADT + RT (HR 0.42; OS immature), while STAMPEDE abiraterone already has OS data, and ENZARAD was negative overall. How does the accumulating data impact which ARPI you use, or whether you intensify at all?
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For very high-risk N0 or cN1 prostate cancer getting definitive RT with long-term ADT, what is your default ARPI intensification?
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Radiation Oncology · UC San Diego
Answered on
The elephant in the room is PSMA PET. And the gorillas in the room are biomarkers (DECIPHER, Artera). I think this space is very exciting, and my practice is likely to continue to change in the near future. For now, all three trials are convincing that there is a benefit for cN1 on conventional imag...
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Medical Oncology · The University of Texas Health Science Center at San Antonio
Answered on
Regarding patient selection, this is an evolving area in medicine. It does appear that disease biology is critical for patient selection, as seen from the positive results in STAMPEDE and the negative results in ENZARAD. More high-risk patients were enrolled in STAMPEDE compared to ENZARAD based on ...
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