Advice for the Next Generation of Urologists in mCSPC Management

In this closing discussion, the panel offers practical advice for new clinicians entering the field of metastatic castration-sensitive prostate cancer (mCSPC) management. The faculty emphasized that this is an exciting and rapidly advancing area of urology, with numerous therapeutic options now improving survival and quality of life. They encouraged junior clinicians to embrace clinical trial participation, stay informed about ongoing research, and gain hands-on experience with all major treatment modalities to build confidence and competence. The conversation also reinforced the importance of early genetic testing, a growing standard in optimizing patient selection and therapy sequencing. Panelists highlighted collaboration between academic and community practices as essential for accelerating innovation and improving patient outcomes. Above all, they advised approaching this field with curiosity, humility, and enthusiasm—recognizing that mCSPC care continues to evolve and that future advances will depend on both rigorous science and real-world clinical engagement.

Panelists noted that abiraterone, apalutamide, and enzalutamide demonstrate overall survival benefits, while darolutamide primarily delays progression. They discussed side-effect profiles and monitoring needs—highlighting the need for liver function monitoring and steroid co-administration with abiraterone—and emphasized that treatment selection often depends on balancing efficacy, toxicity, and clinician comfort.