ABSTRACT BACKGROUND With the availability of second-generation androgen receptor inhibitors (SGARIs), the treatment landscape has changed dramatically for patients with nonmetastatic

castration-resistant prostate cancer (nmCRPC). In clinical trials, the SGARIs (apalutamide, enzalutamide, darolutamide) increased metastasis-free survival (MFS), overall survival (OS), and

patient quality of life compared to placebo. These drugs were subsequently integrated into nmCRPC clinical practice guidelines. With advances in radiographic imaging, disease assessment, and

patient monitoring, nmCRPC strategies are evolving to address limitations related to tracking disease progression using prostate-specific antigen (PSA) kinetics. METHODS A panel of 10

safety profiles and drug-drug interactions. With respect to disease monitoring, a substantial proportion of patients using SGARIs may experience disease progression without rising PSA

levels, suggesting a need for enhanced radiographic imaging in addition to PSA monitoring. Recent data also indicate that novel prostate-specific membrane antigen positron emission

tomography radiotracers provide enhanced accuracy for disease detection, as compared to conventional imaging. CONCLUSIONS Clinical decision-making in nmCRPC has become more complex, with new

opportunities to apply precision medicine to patient care. Multidisciplinary teams can ensure that patients with nmCRPC receive optimal and individualized disease management. Access through

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CONTENT BEING VIEWED BY OTHERS TREATMENT OF NONMETASTATIC CASTRATION-RESISTANT PROSTATE CANCER: FOCUS ON SECOND-GENERATION ANDROGEN RECEPTOR INHIBITORS Article Open access 08 February 2021

NAVIGATING THERAPEUTIC SEQUENCING IN THE METASTATIC CASTRATION-RESISTANT PROSTATE CANCER PATIENT JOURNEY Article Open access 17 October 2024 REAL-WORLD PATIENT CHARACTERISTICS ASSOCIATED

WITH SURVIVAL OF 2 YEARS OR MORE AFTER RADIUM-223 TREATMENT FOR METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (EPIX STUDY) Article Open access 21 February 2022 CHANGE HISTORY * _ 20 APRIL

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https://www.drugs.com/drug_interactions.html. Download references ACKNOWLEDGEMENTS We acknowledge the contributions of Carden Jennings Publishing Co., Ltd., and medical writers Aimee Spevak

and Caitlin Rothermel in assisting in the preparation of this manuscript. FOCUS: Androgen receptor antagonists; castration-resistant prostate cancer; drug interactions; prostate-specific

antigen; quality of life; safety. FUNDING This activity is supported by an independent medical education grant from Bayer for medical writing of this manuscript. AUTHOR INFORMATION AUTHORS

AND AFFILIATIONS * GenesisCare US, Myrtle Beach, SC, USA Neal D. Shore * University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA Emmanuel S. Antonarakis * Northwestern University

Feinberg School of Medicine, Chicago, IL, USA Ashley E. Ross * Johns Hopkins Medical Institutions, Baltimore, MD, USA Catherine H. Marshall * University of Oklahoma Health Sciences Center,

Oklahoma City, OK, USA Kelly L. Stratton, Adanma Ayanambakkam & Michael S. Cookson * University of California, San Diego, La Jolla, CA, USA Rana R. McKay * Mayo Clinic, Phoenix, AZ, USA

Alan H. Bryce * Dana Farber Cancer Institute, Boston, MA, USA Marina D. Kaymakcalan Authors * Neal D. Shore View author publications You can also search for this author inPubMed Google

Scholar * Emmanuel S. Antonarakis View author publications You can also search for this author inPubMed Google Scholar * Ashley E. Ross View author publications You can also search for this

author inPubMed Google Scholar * Catherine H. Marshall View author publications You can also search for this author inPubMed Google Scholar * Kelly L. Stratton View author publications You

can also search for this author inPubMed Google Scholar * Adanma Ayanambakkam View author publications You can also search for this author inPubMed Google Scholar * Michael S. Cookson View

author publications You can also search for this author inPubMed Google Scholar * Rana R. McKay View author publications You can also search for this author inPubMed Google Scholar * Alan H.

Bryce View author publications You can also search for this author inPubMed Google Scholar * Marina D. Kaymakcalan View author publications You can also search for this author inPubMed 

Google Scholar CONTRIBUTIONS EAS, CHM, and AER contributed to section 1—Metastatic Free Survival (MFS) Endpoint. KLS, MSC, and AA contributed to section 2—Safety/Tolerability. RRM and MDK

contributed to section 3—Drug-Drug Interactions. AHB contributed to section 4—Patient Monitoring. All authors contributed to section 5—Current Challenges and Future Considerations.

CORRESPONDING AUTHOR Correspondence to Neal D. Shore. ETHICS DECLARATIONS COMPETING INTERESTS NDS: Consulting fees: AbbVie, Alessa Therapeutics, Amgen, Arquer, Asieris, Astellas, Astra

Zeneca, Bayer, BMS, Boston Scientific, Clarity, Dendreon, Exact Images, Ferring, FIZE Medical, GConcology, GenesisCare, Genetech, Foundation Medicine, ImmunityBio, Incyte, Invitae, Janssen,

Lantheus, Lilly, MDX, Merck, Minomic, Myovant, Myriad, NGM, Nonagen, Novartis, NYMOX, Pacific Edge, Photocure, Pfizer, PlatformQ, Profound, Promaxo, Propella, Protara, Sanofi, Speciality

Networks, Telix, Tolmar, Urogen, Vaxiion, Vessi; Payment for expert testimony: Ferring; Other financial or non-financial interests: Alessa, Photocure Board. ESA: Support for present the

manuscript: Merck; Grants or contracts: Astellas, AstraZeneca, Bayer, Bristol Myers-Squibb, Celgene, Constellation Pharma, MacroGenics, Merck, Orion, Sanofi; Consulting fees: Aikido Pharma,

Corcept Therapeutics, EcoR1, Foundation Medicine, Hookipa Pharma, Invitae, KeyQuest Health, Menarini Silicon Biosystems, z-Alpha; Payment or honoraria for lectures, presentations, speakers

bureaus, manuscript writing or educational events: UroWebinar; Support for attending meetings and/or travel: MJH Events, Research to Practice, Sanofi; Patents planned, issued or pending:

Qiagen; Participation on a Data Safety Monitoring Board or Advisory Board: Aadi Bioscience/CM Propel, Amgen; Board or Advisory Board: AstraZeneca, Bayer, Blue Earth Diagnostics, Ismar,

Janssen, Merck, Sanofi. AHB: Support for present manuscript: Bayer; Grants or contracts: Astellas; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or

educational events: Merck, Pfizer, Janssen, Myovant, Astra Zeneca, Bayer, Astellas, Novartis; Support for attending meetings and/or travel: Pfizer, Bayer. RRM: Consulting fees: AstraZeneca,

Aveo, Bayer, Bristol-Myers Squibb, Calithera, Caris, Dendreon, Eisai, Exelixis, Johnson & Johnson, Lilly, Merck, Myovant, Novartis, Pfizer, Sanofi, SeaGen, Sorrento Therapeutics, Telix,

Tempus; Institutional research support: AstraZeneca, Bayer, Tempus, Oncternal, BMS, Exelixis. KLS: Grants or contracts: Dendreon Pharmaceuticals, Alliance Foundation Trials, Pfizer-B8011006,

TulsaPRO – Perigon, Landmark Services, Janssen-pending, Merck Master Engagement, Medical Director, Surgery Center, Phase IB Trial of Relugolix and Enzalutamide as Neoadjuv; Consulting fees:

Merck & Company Advisory-expired; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Bayer Speaker Bureau 2022, Carden

Jennings Publishing, Elzevier, Ebix Oakstone, National Comprehensive Cancer Network, Society of Urologic Nurses & Associates, ARK Prostate Cancer Symposium; Support for attending

meetings and/or travel: Tulsa Pro Perigon – Onsite Case Observation; American Urological Association; National Comprehensive Cancer Network; Participation on a Data Safety Monitoring Board

or Advisory Board: Merck; Leadership or fiduciary role in other board, society, committee or advocacy group: Society of Urologic Oncology Trials Consortium – Board of Directors, Prostate

Organ Site Comm; Johns Hopkins Medicine/Oakstone Publishing Practical Reviews in Urology; Society of Urologic Oncology-Clinical Trials Consortium Board Of Directors; Society of Urologic

Oncology Young Urologic Oncologist. AA: Nothing to disclose. MSC: Grants or contracts: MDXHealth, Clinical Trial Agreement; Royalties or licenses: Springer Nature Group; Consulting fees:

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