Mechanistic Insights Guiding ARPI Use in mCSPC

Panelists discuss how mechanistic and pharmacologic differences among androgen-receptor pathway inhibitors (ARPIs) influence both drug selection and patient monitoring. While apalutamide and enzalutamide act directly at the androgen receptor, abiraterone inhibits androgen synthesis and requires daily prednisone. These distinctions shape real-world practice by dictating which lab parameters to monitor, which adverse events to anticipate, and how to coordinate follow-up across specialties. Understanding mechanism helps clinicians personalize therapy and educate patients about what to expect.

Panelists discuss how these differences translate into practical care pathways. Abiraterone demands vigilance for hypertension, hypokalemia, and fluid retention; apalutamide and enzalutamide require attention to fatigue, falls, and cognitive effects. The panel stresses clear communication—patients receive written instructions, phone check-ins, and pharmacist support to reinforce adherence. By anticipating issues early, care teams reduce discontinuations and improve safety.

Panelists discuss how tailoring monitoring to each drug’s profile enhances both outcomes and patient confidence. When clinicians explain why certain labs or lifestyle modifications are necessary, patients feel empowered rather than burdened. Thoughtful coordination converts pharmacology into patient-centered management.