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CUA mCSPC Guideline
Local Therapy Systemic Therapy Systemic Therapy
Low Risk/Volume High Risk/Volume
Apalutamide (TITAN)
Level 1, Strong
Enzalutamide (ARCHES, ENZAMET)
Level 1, Strong
Abiraterone with prednisone (LATITUDE)
Level 1, Strong
Docetaxel (CHAARTED)
Level 1, Strong
Radiation to primary (LV) Enzalutamide, not in combination with chemo (ENZAMET)
(STAMPEDE ARM H, HORRAD) Level 2, Strong
Level 2, Strong Apalutamide or Enzalutamide, sequential after docetaxel (TITAN, ARCHES)
Level 1, Weak
Abiraterone with prednisone
Radial prostatectomy in clinical (STAMPEDE ARM G)
trial setting only Level 3, Weak
Expert opinion, Strong
Docetaxel (STAMPEDE ARM C)
Level 2, Weak
