Would you add whole-pelvis radiation as MDT (metastasis-directed therapy) in a patient with 1 pelvic node and 2 osseous metastatic sites for castrate-resistant prostate cancer?

This patient would not fit the PEACE V-STORM eligibility criteria, since the trial excluded patients with distant metastases and did not include patients who were castrate resistant, so I do not think you can extrapolate the results to this patient. One could argue that what you propose to do (SBRT ...

I would offer SBRT to visible disease. In the setting of gross bone metastases, elective treatment for hypothetical microscopic disease has unclear value. The patient and family can be assured that SBRT to oligometastases is already aggressive (and is lacking phase III RCT evidence). This strategy a...

Totally agree with the comments of Professors @Dr. First Last and @Dr. First Last above!

For what it's worth, the recently published continuous ADT part of the EXTEND trial included around 24% CRPC patients, and nearly 2/3 received ARPI as well. The PFS benefit on post-hoc multivariable analysis was ...