Treatment of Metastatic Hormone-Sensitive Prostate Cancer (M1) with Low Disease Volume by CHAARTED Criteria

Clinical Scenario

This protocol applies to male patients with prostate cancer presenting with metastatic hormone-sensitive disease (M1) classified as low volume by CHAARTED criteria:

No visceral metastases
Fewer than 4 bone metastases
No bone lesion extending beyond the vertebral bodies and pelvic bones

Treatment Approach

For eligible patients, androgen deprivation therapy (ADT) combined with additional systemic agents is recommended. Prostate radiotherapy is also incorporated into the treatment plan for this low-volume presentation. The complete combination regimen and full radiotherapy specifications are available in the structured protocol.

Treatment Goals

PSA decline to nadir No radiological progression

Instant Access to Structured Evidence-Based Regimens

References

Offer ADT combined with prostate radiotherapy (using doses up to the equivalent of 72 Gy in 2 Gy fractions) to patients whose first presentation is M1 disease and who have low volume of disease by CHAARTED criteria.

Offer ADT combined with abiraterone acetate plus prednisone or apalutamide or enzalutamide or rezvilutamide to patients with M1 disease who are fit for the regimen.

Do not offer ADT monotherapy to patients whose first presentation is M1 disease if they have no contraindications for combination therapy and have a sufficient life expectancy to benefit from combination therapy (≥ 1 year) and are willing to accept the increased risk of side effects.

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