Collaborative Strategies for ARPI Adherence and Sequencing Management in mCSPC

Panelists discuss how multidisciplinary collaboration among urology, medical oncology, primary care, and pharmacy teams enhances the management of androgen receptor pathway inhibitor (ARPI) therapy and long-term outcomes in metastatic castration-sensitive prostate cancer (mCSPC). They emphasize that treatment success depends on shared responsibility—where urologists oversee disease monitoring, oncologists manage systemic therapy, primary care optimizes comorbid conditions, and pharmacists ensure medication safety and adherence. This coordinated approach reduces care fragmentation, streamlines communication, and prevents complications such as uncontrolled hypertension or missed refills.

Panelists discuss how real-world evidence (RWE) informs both adherence strategies and therapy sequencing once patients progress on first-line ARPI therapy. RWE helps clinicians understand which agents maintain tolerability across diverse populations, how treatment duration influences subsequent response, and which sequencing patterns are most feasible outside controlled trials. By leveraging observational data and patient-reported outcomes, teams can identify when to transition from one ARPI to another or consider introducing other systemic options such as chemotherapy or PARP inhibitors, aligning decisions with real-world experience rather than theoretical assumptions.

Panelists discuss how integrating NCCN guideline recommendations with RWE creates a balanced framework for sequencing decisions. Guidelines provide the evidence-based foundation, while RWE fills practical gaps about adherence, access, and comorbidity management. Multidisciplinary communication ensures that every treatment decision remains patient-centered—optimizing safety, quality of life, and clinical benefit throughout the disease continuum.