<p><strong> </strong><strong>In nmCRPC patients, clinicians should obtain serial PSA measurements at three- to six-month intervals and calculate a PSADT starting at the time of development of castration-resistance. (<em>Clinical Principle</em>)</strong></p>
Discussion
Discussion
<p>Monitoring of men with nmCRPC should include serial measurements of PSA, whether patients are receiving ADT alone or ADT with an additional AR directed therapy (apalutamide, darolutamide, enzalutamide). This allows clinicians to monitor disease status and should be performed every three- to six-months. PSADT should be calculated for men with a rising PSA in the setting of ongoing ADT (castration-resistance) as PSADT is useful in determining which men are at highest risk of developing metastatic lesions or dying from prostate cancer.<sup>107</sup> PSADT <10 months was used to identify the highest risk population for inclusion in the three trials that led to approval of the AR antagonists for men with nmCRPC and is recommended to consider when adding one of the medications to ADT in men with nmCRPC.<sup>15-17</sup><sup> </sup>However, FDA approval of these agents does not specify a doubling time.</p>