@denis76 Of course I worry about castrate resistance, but the alternative — letting the (castrate-sensitive) prostate cancer run rampant — isn't very appealing.

And we do have some control. For mCSPC, multiple trials have shown that taking an ARSI (like Apalutamide) with ADT significant postpones, and in some cases, may even prevent castrate-resistant cancer cells from waking up and taking over, because it also inhibits their own internal signalling.

Meanwhile, trials continue to test whether its ok to discontinue ADT and go on with just ARSI for people with mCSPC who are exceptional responders.