From Tumor Boards to Trials: Evolving Approaches in Oligometastatic Prostate Cancer

A regional roundtable discussion, moderated by Shilpa Gupta, MD, Cleveland Clinic, examined current and emerging strategies in mHSPC and CRPC, including biomarkers and imaging in treatment selection, evolving use of doublet and triplet therapy, ARPI choices and toxicity considerations, and more. Dr. Gupta was joined by other practitioners at Cleveland Clinic, including Christopher Wee, MD; Abdo Haddad, MD; Adriana Alvarez, MD; Moshe Ornstein, MD; and Brian Haines, MD. In the second segment, they discuss the use of PSMA PET scans in staging and monitoring metastatic prostate cancer, including differences in tracers and how to interpret low-volume or borderline findings. They also explore management strategies for oligometastatic castration-sensitive patients, the role of biopsy in suspected progression, and considerations for de-escalating systemic therapy based on response and patient tolerance.