A 75-Year-Old Man with Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)

Neal Shore, MD, FACS, reviews the case of a 75-year-old man with non-metastatic castration-resistant prostate cancer, seeks to evaluate the timeline of rising PSA to determine the aggressiveness of the disease, and considers the patient an excellent candidate for antigen receptor pathway inhibition.

Neal Shore, MD, FACS provides an analysis of the ARAMIS, SPARTAN, and PROSPER trials, which demonstrate improved survival in high-risk non-metastatic castration-resistant prostate cancer through early intervention, highlighting the potential for preventing disease progression based on the data from these pivotal studies.

Neal Shore, MD, FACS, outlines his treatment approach, which favors single agents over combination therapies, and incorporates bone-health drugs, vitamins, nutrition guidance, and exercise recommendations to support patients. While PSA remains a valuable biomarker in prostate cancer, he notes that ctDNA and aspects of MRD are gaining importance, although not yet widely adopted.

Neal Shore, MD, FACS, explains how he integrates findings from the ARAMIS trial to inform patient treatment decisions while prioritizing patient values and personal preferences.

Neal Shore, MD, FACS, concludes by addressing the remaining unmet needs in the management of non-metastatic castration-resistant prostate cancer.