Research To Practice | Oncology Videos Prostate Cancer — Proceedings from a Multitumor Symposium in Partnership with Florida Cancer Specialists & Research Institute
Nov 11, 2025
In this discussion, Dr. Matthew R Smith, a medical oncologist from Massachusetts General Hospital, and Dr. Emmanuel S Antonarakis from the University of Minnesota, delve into the complexities of prostate cancer treatment. They explore the optimization of hormonal therapy and the potential of emerging therapies like PARP inhibitors and radioligand therapies. The conversation highlights the significance of biomarker testing, practical implications of PSMA PET findings, and the challenges of integrating novel approaches into clinical practice.
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GnRH Antagonists: Faster On/Off Advantages
- GnRH antagonists like relugolix achieve faster testosterone suppression without flare and allow faster recovery after discontinuation.
- HERO showed similar general adverse effects to leuprolide but fewer major cardiovascular events, though this was not a primary endpoint.
Start With Treatment Intensification When Appropriate
- Intensify initial therapy for metastatic prostate cancer with ARPIs, docetaxel, or triplet regimens when indicated.
- Use triplet therapy (ADT+docetaxel+darolutamide) for patients who meet criteria, since it improved overall survival in ARISEN.
Enzalutamide Benefits And Unique Toxicities
- Enzalutamide added to ADT improved metastasis-free survival and enzalutamide monotherapy also showed benefit versus ADT alone.
- Enzalutamide monotherapy causes notable breast symptoms and different side effects than ADT.