Evolving Treatment Landscape in mCSPC

Panelists discuss how the treatment landscape for metastatic castration-sensitive prostate cancer (mCSPC) has evolved rapidly, transforming first-line management from single-agent androgen-deprivation therapy to multidrug combinations that extend life while preserving daily function. Over the past 5 years, androgen-receptor pathway inhibitors (ARPIs) such as apalutamide, abiraterone, and enzalutamide have redefined standards of care by improving survival outcomes across diverse patient populations. The panel emphasizes that today’s discussions center on personalization—matching disease burden, comorbidities, and patient priorities to the optimal systemic approach.

Panelists discuss how this evolution has changed clinical workflow. Physicians and advanced practitioners now weigh overall survival benefits against tolerability and convenience, accounting for factors such as steroid coadministration, metabolic monitoring, and pill burden. Shared decision-making is essential; clinicians partner with patients to explain options, address fears of toxicity, and align therapy with lifestyle goals. These nuanced choices underscore the value of multidisciplinary communication and ongoing education.

Panelists discuss how the modern treatment paradigm ultimately benefits patients by broadening access to effective options and encouraging proactive management of side effects. Through collaboration and real-world evidence, clinicians can guide patients toward regimens that provide both longer life and sustained well-being.