Selecting Between Receptor Pathway Inhibitors for mHSPC

Therapeutic Decision-Making in Advanced Prostate Cancer

Key Themes:

• Approach to selecting among multiple androgen receptor pathway inhibitors
• Individualization of therapy based on patient factors
• Consideration of drug-specific characteristics

Expert Insights:

• Dr Shore provided guidance on approaching treatment decisions with multiple agents now available (enzalutamide, apalutamide, abiraterone, and darolutamide).
• He emphasized the importance of individualizing therapy based on comorbidities, potential drug-drug interactions, convenience factors, and patient preferences.

The discussion noted darolutamide's lower central nervous system penetration and potentially improved tolerability in certain populations, while acknowledging that all these agents represent effective treatment options.