Table 9. Key treatment recommendations.

Recommendations		Agreement by panelist
Combination therapy vs. ADT alone
	Consensus was reached on recommending ADT intensification over ADT alone, irrespective of disease volume or whether the disease is metachronous or synchronous	Synchronous HV: 100.0% Synchronous LV: 87.0% Metachronous HV: 100.0% Metachronous LV: 95.7%
	For treatment intensification, ARPI in addition to ADT is recommended by all panelists for the majority of patients with mHSPC	100.0%
Docetaxel addition
	Docetaxel alone is not recommended by any panelists for addition to ADT when an ARPI is available for intensification	100.0%
Pathogenic SPOP mutation
	For patients with high-volume mHSPC and a pathogenic SPOP mutation, ADT+ARPI is recommended by all panelists over docetaxel doublet or triplet therapy as the systemic therapy	100.0%
Monitoring
	Consensus was reached on recommending regular imaging every 3 months, regardless of PSA levels, under the current local reimbursement guidelines that were based on clinical trials	82.6%
	If there are no strict reimbursement guidelines, the recommendation changes to regular imaging every 6–12 months, regardless of PSA levels	87.0%
Oligometastatic mHSPC
	ADT+ARPI is the most recommended systemic treatment option by all panelists	100.0%

ADT, androgen-deprivation therapy; HV, high-volume; LV, low-volume; ARPI, androgen receptor pathway inhibitor; mHSPC, metastatic hormone-sensitive prostate cancer; SPOP, speckle-type poxvirus and zinc finger protein; PSA, prostate-specific antigen.