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In patients with NCCN-defined very high risk localized prostate adenocarcinoma who have a contraindication to abiraterone plus prednisone, do you consider starting ARPI (such as enzalutamide) instead, in addition to ADT?
If so, when do you typically start it?
Answer from: Medical Oncologist at Academic Institution
Absolutely. Abiraterone in this setting improves OS, MFS, and likely long-term remission/cure rates over 10+ years when combined with radiation and standard of care radiation. Suppose a patient cannot tolerate abiraterone or prednisone due to various comorbidities (e.g., diabetes, steroid intoleranc...
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