@denis76 I suggest not trying to spitball this. The reason metastatic castrate-resistant cancer cells sometime become predominant in a low-testosterone environment is that the castrate-sensitive cancer cells are blocked; if you don't block them, they'll just spread the cancer even more quickly themselves.

Research on ADT holidays published in 2012/13 didn't find that the breaks delayed castrate resistance, as far as I remember; just that they decreased risks from side effects. And overall survival time actually *decreased* with ADT holidays for stage 4 prostate cancer.

However, your plan to stay on Erleada is a good one. ARSIs weren't in widespread use when the data was collected for those 2012/13 studies, and things are in flux.

For your and my specific situation — stage 4 castrate-sensitive PCa that responds well to ADT+Erleada — the LIBERTAS trial currently underway is testing whether it's safe to drop the ADT and continue with just Erleada, like you're considering. The first results are due out this fall, and final results next year. It would be a good time to start discussing that trial with your oncologist, as I have with mine.

p.s. I've been on ADT+Erleada continually since October 2021, and have not developed castrate-resistance: my PSA remains undetectable on the ultrasensitive test (< 0.01).