Thanks for sharing that. Two questions:

1. They compare % of participants with radiographic progression (rPD) but no PSA rise. To what extent is that accounted for by the fact that the study group (on ADT+Enzalutamide) had less much less rPD than the control group (just ADT) in the first place?

2. They refer to "any PSA rise from baseline/nadir by treatment" without disaggregating how low the nadir was or which test (PSA or uPSA). They probably didn't have a choice, since it was a retrospective review.

Still, the conclusion makes sense: it doesn't say "don't use an ARPI" (since there are huge overall survival benefits); instead, it recommends not relying 100% on PSA monitoring, but to do periodic imaging as well (which seems uncontroversial).