Upfront Testing and Monitoring: Practical Approaches in Metastatic 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 first segment, they begin with a discussion on how clinicians are approaching mHSPC. They discuss the role of germline and somatic testing, the influence of genomic alterations on treatment intensification decisions, and evolving practices around PSMA PET imaging versus conventional scans for staging, monitoring response, and guiding management.