Which patients with metastatic hormone sensitive prostate cancer would you treat with enzalutamide or apalutamide (instead of abiraterone or docetaxel)?

Current studies in mHSPC combining docetaxel or abiraterone or enzalutamide or apalutamide suggest that the standard of care for patients who present with de novo high volume metastatic disease has now changed from single ADT (gonadal androgen suppression) to one of the combinations. At this point i...

I agree with my astute mentor on most of his responses! However, I would not discount the PFS and overall survival benefits of these AR therapies in men with low volume or oligometastatic HSPC. In ENZAMET, for example, the HR for OS in low volume patients is 0.43 (95% CI 0.26-0.72) and ARCHES confir...