Phase III mHSPC trials can take up to a decade to complete when OS is used as the primary endpoint. The addition of apalutamide to ADT should be considered in patients with high-risk BRPC, according to researchers. Dr. Wallis highlights his population-based research on treatment intensification shortcomings in de novo mCSPC. Researchers evaluated real-world survival for patients with mCSPC who received enzalutamide or apalutamide treatment. Researchers noted a lack of research surrounding treatment-related adverse events in these patients. Drs. Shen and Graff discuss patient outcomes from TITAN and SPARTAN, as well as assessing functional vs chronological age. Compared with ADT alone, apalutamide plus ADT had a favorable hazard ratio across all end points regardless of age. The trio highlights the results of a study on whether bone scans overstage PC compared with PSMA PET at initial staging. A background on PSMA PET scans for staging of prostate cancer and comparison of accuracy of conventional vs PSMA PET imaging. Research shed light on the safety and efficacy of pembrolizumab plus enzalutamide and ADT in patients with NHA-naïve mHSPC. Investigators used plasma samples from the ORIOLE study to conduct a blind validation study based on this new research. The PNI is commonly used as a prognostic factor for malignant tumors, but its potential use for prostate cancer is unknown. SNMMI convened an autonomous workgroup to review prospective phase 2/3 clinical trials that used 177Lu-PSMA-617. Multiple genitourinary oncology therapies are in the spotlight this week, with new US FDA indications on the horizon. The phase 3 TITAN study assigned patients with mCSPC apalutamide or placebo with ADT to determine its effects on PFS and OS. Patients with a suboptimal PSA response who are administered intensified ADT often experience worse survival outcomes. A meta-analysis sought to determine the efficacy of systemic therapies in patients with PCa and poor performance status. Drs. Bossi and Wallis conclude with a breakdown of the right patients for radiotherapy when presenting with de novo mCSPC. Drs. Bossi, Wallis address which patients with mCSPC experience synergistic effects from abiraterone plus radiotherapy. Drs. Bossi and Wallis break down the results of the PEACE-1 study presented as an LBA at the ASCO Annual Meeting.