Dr. Ciuro discusses key factors to consider when choosing between doublet and triplet therapy for mHSPC. The panel highlights the limitations of conventional imaging in detecting disease progression at undetectable PSA levels. The panel zooms in on the use of radium, enzalutamide, and other therapeutic agents, touching on patient preference trials. The panel focuses on decision-making between AR antagonists and abiraterone, weighing factors such as reimbursement. The panel goes in-depth on the use of testing and SBRT as metastasis-directed therapy in newly diagnosed prostate cancer. The panel explores the the role of imaging, genomics, and patient factors in the management of mHSPC. In 53.3% of cases, PSMA PET positively identified bone disease despite negative findings on bone scintigraphy. In the final segment, the panel emphasizes the importance of trust in the patient-provider relationship. The panel exchanges strategies on sequencing and debates the potential of immunotherapy in prostate cancer. In part four, the panel shares thoughts on the implications of recent trials including ARASENS, ARANOTE, and PEACE-3. The panel discusses nuances to consider when using PSMA PET imaging, including differentiating false positives. Experts discuss managing prostate cancer progression, risk stratification, and balancing treatment with quality of life. Expert panel discusses diagnostic criteria, precision medicine, and PSMA imaging in managing metastatic prostate cancer. The panel explores the distinct roles of alpha and beta emitters in radiopharmaceutical therapy for prostate cancer care. The expert panel discusses emerging biomarkers and treatment combinations for CRPC and mHSPC. The evolving role of RLT and radium-223 in managing metastatic mHSPC and CRPC is discussed. The panel examines the impact of the latest data from ARANOTE and PEACE-3 in part three of this roundtable. The panelists discuss key considerations for patient selection in doublet and triplet therapies for mHSPC and CRPC. In part one of this roundtable, the panel discusses advances in imaging and tailored treatment strategies for prostate cancer In part four of this roundtable series, the panelists discuss CRPC and the typical patterns of presentation.