Treatment Patterns in Advanced Prostate Cancer from Monotherapy to Treatment Intensification

In this episode, the expert urologists and medical oncologists explore the following critical questions:

1. Can you comment on treatment trends in the use of ADT monotherapy versus doublet and triplet therapy in mCSPC in clinical practice?
   1. What are some areas where management of mCSPC can be improved?
   2. How does genetic testing at diagnosis influence your treatment decisions around therapy intensification in mCSPC?

Led by the moderator, the multidisciplinary panelists examine how treatment patterns in advanced prostate cancer have shifted from widespread ADT monotherapy toward increasing use of doublet and triplet therapy, supported by real-world evidence. Faculty highlight data showing substantial adoption of treatment intensification in mCSPC, while acknowledging that a significant proportion of patients still do not receive combination therapy early. The discussion underscores ongoing gaps in the use of genomic and next-generation sequencing testing, despite the availability of targeted therapies and guideline recommendations. Finally, the panel emphasizes education—across urology, oncology, and patients themselves—as critical to sustaining momentum as new therapies and precision approaches continue to emerge.

The next episode in this series, ‘Patient Conversations When Initiating ADT for Prostate Cancer,’ features the panelists exploring patient counseling at ADT initiation, focusing on quality-of-life preservation, lifestyle interventions, and proactive management of treatment-related effects. The panel also shares real-world experience with oral ADT tolerability and the importance of long-term monitoring as patients live longer on therapy.