Facharzt FMH Urologie Practice Questions - Facharzt FMH Für Urologie Spécialiste FMH En Urologie Exam

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A 60-year-old man presents with bone pain. Workup reveals de novo metastatic hormone-sensitive prostate cancer (mHSPC) with extensive bone metastases (8 lesions across the spine and pelvis, including 4 outside the axial skeleton) and multiple pelvic lymph nodes (high-volume disease by CHAARTED criteria). His ECOG performance status is 0. Based on the PEACE-1 and ARASENS trials and current EAU guidelines, what is the preferred first-line systemic treatment?

Triplet therapy: Androgen deprivation therapy (ADT) plus docetaxel chemotherapy plus an androgen receptor pathway inhibitor (darolutamide or abiraterone) ADT monotherapy with an LHRH agonist alone, reserving novel antiandrogens for castration resistance Docetaxel monotherapy for 6 cycles without androgen deprivation therapy Bicalutamide 50 mg daily monotherapy with palliative focal bone radiotherapy

Correct Answer:

Triplet therapy: Androgen deprivation therapy (ADT) plus docetaxel chemotherapy plus an androgen receptor pathway inhibitor (darolutamide or abiraterone)

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