Patient Counseling for Doublet versus triplet Therapy in mCSPC

This segment focuses on the art of patient counseling when deciding between doublet and triplet therapy for metastatic castration-sensitive prostate cancer (mCSPC). Panelists emphasize that while clinical factors guide treatment selection, patient discussions must address personal values, treatment goals, and quality of life considerations. Physicians described framing the conversation around key priorities—preventing disease progression, prolonging life, and preserving function—while tailoring treatment intensity to the patient’s health status and preferences. The dialogue highlights the need for shared decision-making, ensuring patients understand both the potential benefits and trade-offs of therapy, particularly regarding chemotherapy-associated toxicities. The panel also reflects on the importance of normalizing chemotherapy, clarifying that modern regimens like docetaxel are better tolerated than many patients assume. Ultimately, effective communication and empathy are essential to align therapeutic strategies with patient expectations, reinforcing that treatment success extends beyond survival to maintaining quality of life.

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.