Metastatic Prostate Cancer

Authored by Axel Merseburger, published on 2026-02-26 16:33:12.0

Metastatic prostate cancer treatment algorithm outlining evidence-based therapy pathways between Hormone-Sensitive and Castration-Resistant prostate cancer. Reference diagram.

  1. Metastatic Prostate Cancer
    • Castration-Resistant
      • Continue ADT
        • ARPI: Abi/Enza/Daro/Apa PARPI: Olaparib/Rucaparib Docetaxel Radium-223 Lutetium-177 PSMA Immunotherapy
          • Best available option afterward: Clin Trial or switch to ARPI, Docetaxel, Cabazitaxel, or Lutetium-177 PSMA if not yet used
            • Consider adding Bone-Targeting Agent
    • Hormone-Sensitive
      • ADT + ARPI (Abi/Enza/Daro/Apa) or ADT + Docetaxel + Apa or Abi
        • Continue ADT + ARPI (Abi/Enza/Daro/Apa) Maintenance
          • Consider adding Bone- Targeting Agent
  2. Radiation Therapy of the Prostate in low volume (oligometastic) disease
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