When is the best time to start denosumab in men with metastatic prostate cancer?

The data supporting the use of bone modifying agents (BMAs) such as denosumab or zoledronic acid are certainly the most solid for men with castration-resistant prostate cancer (i.e. progresion of disease through inital LHRH analog therapy) (Saad, JNCI 2004; 94: 1458–68; Fizzazi Lancet Oncol 2011; 37...

I believe the question pertains to role of BMAs in castration sensitive prostrate cancer (CSPC). With regard to castration sensitive disease, the phase 3 trial which studied Zometa did not show decrease in SREs or improvement in OS (J Clin Oncol. 2014;32(11):1143. Epub 2014 Mar 3). Median follow up ...