Arab Board Urology Clinical Exam Practice Questions - Arab Board Of Health Specializations Urology Final Clinical And Oral Exam

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A 71-year-old male presents with bone pain and is diagnosed with de novo metastatic hormone-sensitive prostate cancer (mHSPC). Staging 68Ga-PSMA PET/CT demonstrates multiple avid lesions across the lumbar spine, pelvis, and ribs (high-volume disease by CHAARTED criteria), with a baseline PSA of 185 ng/mL and normal organ function. What represents the current evidence-based first-line systemic management?

Triplet systemic therapy with ADT, docetaxel chemotherapy, and an AR pathway inhibitor (darolutamide or abiraterone) Continuous bicalutamide 50 mg monotherapy Immediate bilateral open orchiectomy alone without any further systemic agents External beam radiation therapy to the prostate without systemic therapy

Correct Answer:

Triplet systemic therapy with ADT, docetaxel chemotherapy, and an AR pathway inhibitor (darolutamide or abiraterone)

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