Patient Selection for Monotherapy in High-Risk Biochemical Recurrence Prostate Cancer

In this segment, Dr. Graham and Dr. Sokolova return to the biochemical recurrence (BCR) prostate cancer setting to discuss considerations around monotherapy in patients with high-risk disease. The conversation focuses on how clinicians approach patient selection in light of data showing no demonstrated overall survival benefit, while acknowledging potential advantages related to quality of life and tolerability. Dr. Graham highlights the importance of evaluating individual disease characteristics, PSA kinetics, patient comorbidities, and treatment goals when considering monotherapy approaches. Both experts emphasize that these decisions are highly individualized and should involve shared decision-making with patients. The discussion underscores the need to balance disease control with minimizing treatment burden, particularly for patients who may prioritize maintaining daily function. Overall, this segment provides a balanced perspective on how clinicians navigate complex trade-offs in managing high-risk BCR prostate cancer.