Individualizing Systemic Therapy Strategies in Prostate Cancer
June 23, 2026
Videos
PEER-TO-PEER CLINICAL CONVERSATIONS
Real-World Testosterone Recovery After Relugolix: Interim Results from the OPTYX Registry
Benjamin Lowentritt, MD, FACS
Benjamin Lowentritt presents interim results from the phase 4 OPTYX registry evaluating real-world testosterone suppression and recovery among patients receiving relugolix, highlighting how ADT selection, reversibility, and planned treatment breaks may inform individualized prostate cancer care.
Implementation of the PC360 Algorithm to Manage Cardiovascular and Bone Health Risks on ADT
Jason Hafron, MD, CMO
Jason Hafron describes implementation of the PC360 algorithm to help identify and manage cardiovascular, bone health, neurocognitive, and lifestyle risks in patients receiving ADT. Drawing on a 300-patient pilot, he highlights how chronic care management can help close monitoring gaps and coordinate care across specialties.
De-Escalation of ADT and AR Pathway Inhibitors in mHSPC: The A-DREAM Trial
Atish Choudhury, MD, PhD
Atish Choudhury presents A-DREAM trial results evaluating treatment cessation after deep PSA response in mHSPC, raising practical questions about patient selection, treatment duration, and de-escalation of ADT plus AR pathway inhibitor therapy.
Testosterone Suppression and Recovery in Patients with Advanced Prostate Cancer Treated with Relugolix: An Interim Analysis of the OPTYX Study
Benjamin Lowentritt, MD, FACS
In the real-world OPTYX study, relugolix produced rapid and sustained testosterone suppression in both monotherapy and combination-therapy patients, with more than 90% reaching castrate levels by 6 months. After discontinuation, testosterone often recovered quickly and PSA remained suppressed for up to 6 months, supporting the role of ADT reversibility as one factor in individualized treatment planning.
Prevalence of Major Adverse Cardiac Events in Men with Prostate Cancer Receiving ADT in Real-World Clinical Practice
Andrew Hahn, MD
In this real-world study of 17,336 men starting ADT, overall MACE rates were low, but they were much higher in patients with baseline cardiovascular disease. GnRH antagonists had numerically lower MACE rates than GnRH agonists, and relugolix users had the lowest event rates, supporting careful cardiovascular risk assessment when selecting ADT as part of a broader systemic therapy strategy.
EORTC GUCG 2238 – DE-ESCALATE: A Pragmatic Trial to Revisit Intermittent ADT in mHSPC in the Era of New ARPIs
Fabio Turco, MD
DE-ESCALATE is a pragmatic phase III trial evaluating whether mHSPC patients who achieve PSA ≤0.2 ng/mL after 6–12 months of maximum androgen blockade can safely stop treatment and use an intermittent approach instead of continuous therapy. The trial will assess time off therapy, 3-year overall survival, toxicity, quality of life, and resource use.
Potential for Drug-Drug Interactions with Novel ARTAs and Concomitant Medications: Analysis Based on the Metastatic Hormone-Sensitive Prostate Cancer Patients in the Real-World Evidence RECOMMEND Study
Amit Bahl, MBBS, FRCR
This RECOMMEND analysis highlights the importance of concomitant medications when selecting AR pathway inhibitors in mHSPC, showing differences in potential drug–drug interactions across darolutamide, apalutamide, and enzalutamide. The findings reinforce the need to individualize systemic therapy based on comorbidity burden, polypharmacy, and treatment goals.
Major Adverse Cardiovascular Events in ARPI-Treated Patients with mCSPC
Linden Huhmann
In this VA mCSPC cohort, darolutamide was associated with fewer major adverse cardiovascular events than abiraterone, particularly in doublet therapy. These real-world findings contribute to the broader discussion around ARPI selection and cardiovascular risk management in ADT-based treatment.
