Research To Practice | Oncology Videos Prostate Cancer — Proceedings from a Multitumor Symposium in Partnership with Florida Cancer Specialists & Research Institute
Nov 11, 2025
In this discussion, Dr. Matthew R Smith, a medical oncologist from Massachusetts General Hospital, and Dr. Emmanuel S Antonarakis from the University of Minnesota, delve into the complexities of prostate cancer treatment. They explore the optimization of hormonal therapy and the potential of emerging therapies like PARP inhibitors and radioligand therapies. The conversation highlights the significance of biomarker testing, practical implications of PSMA PET findings, and the challenges of integrating novel approaches into clinical practice.
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Use Intermittent ADT+Enzalutamide For High‑Risk BCR
- For biochemical recurrence with negative PSMA PET and rapid PSA doubling time, start ADT plus enzalutamide and consider stopping after nine months if PSA <0.2.
- Restart systemic therapy later with repeat PSMA imaging if PSA rises above trial thresholds.
Choose GnRH Agent Based On Duration And Cardiac Risk
- Prefer degarelix induction then switch to long‑acting leuprolide for patients at risk of flare or with cardiovascular disease concerns.
- Reserve relugolix for short-term ADT (e.g., six months) or when quick on/off control is required.
Darolutamide's Safety Profile Stands Out
- Darolutamide has a favorable tolerability and minimal CNS penetration compared with other ARPIs, making it a front-runner for many clinicians.
- All ARPIs are generally well tolerated with low discontinuation rates.