Navigating Treatment Decisions in Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)

Paul E. Dato, MD, discusses how a 69-year-old Black man presented with metastatic hormone-sensitive prostate cancer, showing symptoms of fatigue, nocturia, back pain, and weight loss, with initial treatment including androgen deprivation therapy and abiraterone acetate.

Paul E. Dato, MD, discusses how when selecting abiraterone for metastatic hormone-sensitive prostate cancer patients, there are 3 formulations to consider: standard, generic, and micronized versions, with considerations for bioavailability, fasting requirements, and patient adherence.

Paul E. Dato, MD, discusses how formulation and dosing differences between abiraterone options affect absorption and tolerability, with the micronized version potentially providing better compliance due to no fasting requirement, though insurance coverage remains a significant hurdle for its use.

Paul E. Dato, MD, discusses how the presence of a BRCA mutation can influence treatment selection and sequencing, supporting consideration of upfront triplet therapy intensification and planning for earlier integration of PARP inhibitors when castration resistance develops.