Treatment Decisions in Patients With Low- vs High-Volume Disease

Author(s):

A panelist discusses how these comparative results could influence clinical decision-making by suggesting potentially different magnitudes of benefit between enzalutamide and darolutamide depending on disease volume, with the treatment effect differences possibly being more pronounced in high-volume disease patients, although individual patient factors should still guide personalized therapy selection.

EP: 1.Matching-Adjusted Indirect Comparisons in mHSPC

EP: 2.Key Limitations of MAIC Analyses

EP: 3.Study Design: Comparing the ARCHES and ARANOTE trials

EP: 4.Key Takeaways From an Indirect Comparison of ENZA and DARO in mHSPC

EP: 5.Key Differences Between Enzalutamide and Darolutamide

EP: 6.Deciding on a Treatment Approach for mHSPC

EP: 7.Findings in the Docetaxel-Naive Patient Population

Now Viewing

EP: 8.Treatment Decisions in Patients With Low- vs High-Volume Disease

EP: 9.Real-World Experience of ENZA vs DARO

EP: 10.Explaining Study Results to Your Patients

Summary for Physicians: Treatment Decisions Based on Disease Volume

The impact of disease volume (high vs low) on treatment selection:

Both androgen receptor (AR) pathway inhibitors (enzalutamide and darolutamide) demonstrate benefit regardless of disease volume.
The magnitude of benefit may differ between high-volume and low-volume disease subgroups.
In high-volume disease: Consider more aggressive approaches; combination therapy may provide more substantial benefits.
In low-volume disease: AR pathway inhibitors show particularly favorable outcomes, potentially allowing some patients to delay chemotherapy.

Clinical decision-making implications:

Disease volume should be 1 factor among several in treatment selection.
Individual patient characteristics (age, comorbidities, performance status) remain critical considerations.
Treatment goals (rapid disease control vs quality-of-life prioritization) may vary based on disease burden.
Regular reassessment of disease status is important as volume can change over time.

Treatment decisions should be individualized through shared decision-making that considers disease volume alongside other patient-specific factors.