Evolving Treatment Landscape in Metastatic Castration-Resistant Prostate Cancer (mCRPC)

An expert discusses how combining androgen receptor pathway inhibitors (ARPIs) with PARP inhibitors, particularly enzalutamide with talazoparib, has significantly improved outcomes in metastatic castration-resistant prostate cancer (mCRPC)—especially for patients with homologous recombination repair (HRR) mutations—underscoring the importance of early genomic testing and personalized combination therapy.

An expert discusses how treatment decisions in metastatic castration-resistant prostate cancer (mCRPC) increasingly depend on prior androgen receptor pathway inhibitor (ARPI) exposure, highlighting the need for individualized therapy sequencing based on evolving practice patterns and patient history.

An expert discusses recent trial data showing that combining radium-223 with enzalutamide modestly improves outcomes in metastatic castration-resistant prostate cancer (mCRPC) with bone metastases—highlighting the necessity of bone-modifying agents to reduce fracture risk—while results from the TRITON3 trial underscore the greater efficacy of PARP inhibitors such as rucaparib when used early and in combination for BRCA-mutated patients.

An expert emphasizes that genomic profiling—including both germline and somatic testing—is now essential in metastatic prostate cancer management because it identifies key mutations such as homologous recombination repair (HRR) gene alterations that guide targeted therapies such as PARP inhibitors, informs the use of immune checkpoint inhibitors in select cases, and helps predict disease aggressiveness to tailor monitoring and treatment strategies.

An expert highlights that safety considerations in metastatic castration-resistant prostate cancer (mCRPC) treatment depend on prior therapies and disease status, emphasizing early combination therapy for better control, vigilant bone health management with bone-modifying agents, proactive adverse effect mitigation, and the importance of exercise, nutrition, and cardiovascular monitoring to optimize patient outcomes and quality of life.

An expert emphasizes that treatment decisions for metastatic castration-resistant prostate cancer (mCRPC) are highly personalized, balancing clinical efficacy with patient lifestyle, quality of life, and preferences—prioritizing overall survival alongside minimizing adverse effects and hospital visits—while endorsing flexible treatment durations, including breaks and dose adjustments, to maintain both effectiveness and patient well-being through shared decision-making.