Monitoring Treatment Response in mCSPC

This episode, titled ‘Monitoring Treatment Response in mCSPC,’ features panelists discussing how they monitor patients receiving doublet therapy and assess treatment response over time. The expert faculty highlight the importance of combining clinical evaluation, laboratory testing, and imaging to guide management decisions and identify disease progression as early as possible. The panel explains that PSA remains a cornerstone biomarker for monitoring treatment effectiveness, with routine assessments performed after treatment initiation and at key follow-up intervals. However, they emphasize that PSA alone is not sufficient, as some patients may experience radiographic progression despite stable or undetectable PSA levels.

As a result, the panelists discuss the growing role of routine imaging in mCSPC, including baseline staging studies and periodic surveillance imaging performed throughout treatment. The expert faculty review how imaging findings, changes in PSA kinetics, laboratory assessments, and patient-reported symptoms collectively influence treatment decisions. Particular attention is given to identifying progression before the onset of clinically significant symptoms, as patients who develop pain or other complications before progression is recognized may experience worse outcomes. The panel discusses how symptoms such as bone pain can serve as important warning signs that warrant additional evaluation.

The conversation also explores practical challenges associated with imaging surveillance, including limited access to PSMA PET imaging and the continued need for conventional imaging modalities. Panelists share real-world experiences using CT scans, MRI, and other imaging approaches to monitor disease status and detect progression that may not be reflected by PSA changes alone. Overall, the panel underscores the importance of proactive monitoring strategies to optimize outcomes and support timely treatment adjustments for patients with mCSPC.

In the next episode, ‘Integrating Biomarker Testing and Emerging Targeted Therapies in mCSPC’, panelists will discuss the growing role of germline and somatic testing in treatment selection and explore how emerging targeted therapies, including PARP inhibitors and capivasertib-based approaches, may influence the future management of mCSPC. The panel also highlights the significance of PTEN loss, biomarker identification strategies, and the practical considerations associated with adopting these novel therapies into clinical practice.