Would you consider adding abiraterone or docetaxel in patients with high risk prostate cancer whose PSA does not become undetectable after ADT and radiotherapy with castrate level testosterone?

There are three concepts here at its core:

1. Does adding abi or doce to ADT/RT in high-risk PCa improve outcomes in unselected patients?
2. Does a detectable PSA while on ADT impact prognosis?
3. Does intensifying therapy in patients with a detectable PSA while on ADT improve outcomes in this subset?

Here a...

The concept of adding additional treatment to standard ADT after radiation in patients who do experience undetectable or very low PSA’s is very appealing.
Many studies have demonstrated that patients who do not reach this PSA endpoint have poorer outcomes. For instance: Bryant et al., PMID 29727915,...

I presume by "high risk", you refer to locally advanced disease. While there is no data regarding this issue regarding docetaxel, the STAMPEDE study did address this issue in men with locally advanced disease receiving ADT and radiotherapy with the addition of abiraterone/prednisone demonstrating be...

I presume you mean detectable and stable or falling and not rising.

Can consider - Docetaxel - based on RTOG 0521 that used adjuvant Docetaxel for 6 cycles after planned RT. There was benefit for DFS and OS at 6 years (planned was 4 years).

I don’t believe they stratified based on post therapy PSA - ...