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In patients with NCCN definition very high risk localized prostate adenocarcinoma, who have contraindication to abiraterone plus prednisone, do you consider starting ARPI (like enzalutamide) instead in addition to ADT?
When do you typically start it, if considering?
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. If a patient cannot tolerate abiraterone or prednisone due to various comorbidities (diabetes, steroid intolerance, cardiac ...
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