PSA Nadir main deciding factor when one can start on Intermittent ADT?

Jeff,
I was reading about another Biomarker Test "Oncotype DX" Genomic prostate score that accurately predicts long-term risk of metastasis and death in men with localized disease. They have certain eligibility restrictions for this test like "No biopsy in the last 3 years" which I don't understand.
Are you aware of this?

Excellent information! Gleason 9 Grade 5, staging 3ab, Cribriform 3,4,5. RP 2.5 years ago, BCR .22 at 2-year post RP. Undergoing 25 salvage with 6 months ADT. Seems light from what you pasted.
Thank you for the information. Sadly, no NCCN center here.
Chip

So, my experience...

I've done ADT twice, first was as part of triplet therapy staring in January 2017. Original treatment plan was six cycles of Taxotere, 24 months Lupron (8x90 day shots) and WPLN radiation (25 IMRT 45 Gya). There was also consideration to adding an ARI should my PSA not drop to undetectable in the first six months.

We did not have to add the ARI and Dr. Kwon agreed to stop Lupron at 18 months based on my response to treatment and studies that looked at 36 vs 24 vs 18...

The next time was in April 23 when I did SBRT (5x8Gya) and 12 months of Orgovx. My oncologist wanted to do 24 months based on studies such as EMBARK, he also wanted to add an ARI. I pushed back discussing studies that pointed to 6-12 months combined with SBRT. We reached a shared decision, SBRT, 12 months of Orgovyx, only add the ARI if PSA did not drop to undetectable in the first three months, labs and consult every three months, then revisit the decision at 12 months, decide whether to come off treatment or continue to 24.

We did not add the ARI based on my response, we stopped at 12 and per our original decision, do labs and consults every three months. PSA tests over the first nine months are "undetectable," next one is in April.

Both times my T recovered rapidly in the first three to six months. Time off treatment the first time was roughly four years, second time at 10 months currently.

I am high risk - GS 8, GG4, rapid PSADT and PSAV, 18 months to BCR...

Kevin

@heavyphil has already said what I would recommend you inquire about.

NCCN is a standards group that sets guidelines for treatment of cancer. Doctors use it to backup their recommendations.

The strange thing is that the test requires tissue from a biopsy?

Now that needs clarification.