Dr. Syan shares her vision for the meeting and the lessons or feedback from the past two years that helped shape the program. Dr. Sanchez-Salas comments on whether PSMA PET is useful for determining optimal candidates for focal therapy. Dr. Sanchez-Salas details strategies for selecting between focal therapy versus active surveillance or definitive treatments. Dr. Kaouk presented on the benefits of surgery for managing biochemically recurrent prostate cancer post-radiation. Dr. Thompson, Jr. highlights his recently published large dataset of long-term complications of prostate cancer treatment. Conventional imaging may understage patients with HR nmHSPC compared to PSMA-PET imaging. Drs. Saji and Lebastchi explore focal therapy, covering its historical evolution, techniques, and energy modalities. Patients with BRCA mutations had a higher risk of death, while patients with PTEN/TP53/RB1 mutations did not. Dr. David Morris discusses the emerging role of copper-based PSMA imaging agents, specifically 64Cu-SAR-bisPSMA. Dr. Ghazi is recognized as a pioneer in patient-specific surgical simulation, using state-of-the-art techniques in surgery. Clarity Pharmaceuticals announced that the first two participants in Co-PSMA have been dosed with its proprietary medication. Standard risk assessment plus genomic classification for prostate cancer surveillance helps predict disease progression. 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 Drs. Saji and Lebastchi provide an in-depth overview of focal therapy for prostate cancer, including HIFU and IRE therapies. Radical prostatectomy with pelvic lymph node dissection increases risks of complications like DVT and lymphatic leaks.