Metastatic (M1) castration resistant prostate cancer
Scottish Cancer Network: Clinical Management Pathways
Warning
What's new / Latest updates
18/12/2025
Prior docetaxel plus ARPI is a new pathway added for patients who progress following treatment with triple therapy of docetaxel, ARPI and ADT.
27/08/2025
Talazoparib in combination with enzalutamide added for metastatic castration-resistant prostate cancer.
Talazoparib in combination with enzalutamide added for metastatic castration-resistant prostate cancer.
Addition made to: "Prior LHRH analogue alone", "Prior docetaxel (no prior ARPI)" and "Progression during Androgen Receptor Pathway Inhibitor Therapy (ARPI)" pathways. Minor updates made to pathways for clarity around this change.
Treatment of castration resistant metastatic prostate cancer depends on prior therapies the patient has already received.
Please refer to the appropriate treatment page below based on the patient's prior treatment.
HRD/BRCA testing is encouraged where possible.
First line ARPIs (androgen receptor pathway inhibitors) can be switched to an alternative due to patient intolerance, but ARPIs should not be used in sequence in the event of disease progression during ARPI treatment.
The printing of visual pathways is strongly discouraged, due to the inability to print all relevant information contained within and behind the pathways. Any user choosing to do so must acknowledge that the information may be incomplete and that essential context may be missing from a printed or reproduced pathway.
| Author | Rob Jones (on behalf of SACT subgroup) | Reviewer | Alan McNeill |
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Date of creation Update |
28/05/2025 18/12/2025 |
Version number | 1.2 |
| Description of last update |
Prior docetaxel plus ARPI
New pathway added for patients who progress following treatment with triple therapy of docetaxel, ARPI and ADT. |
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| Review Date | 28/05/2028 | Contact | nss.scottishcancernetwork@nhs.scot |