Metastatic (M1) hormone sensitive prostate cancer

Defining disease as high/low risk:

Treatment of metastatic (M1) hormone sensitive prostate cancer is based on classification of disease as 'high risk' or 'low risk', as described in the below table.

Treatment options:

Treatment options are outlined in the below sections for 'high risk' and 'low risk' disease.

Please note the following caveats to treatment.

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.Surgical or medical castration should occur prior to commencing any other treatments.

Medical castration with a luteinising hormone-release hormone (LHRH) analogue should be continued during treatment of patients not surgically castrated.

ADT alone may be used for metastatic hormone sensitive prostate cancer.

See the "androgen deprivation therapy" page for more information: Androgen Deprivation Therapy