{"entity":{"id":"mcrpc-mhspc","kind":"term","name":"mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer)","aka":["castration-resistant","castration resistant","castrate-resistant","mCRPC","nmCRPC","CRPC","castration-sensitive","castration sensitive","hormone-sensitive","hormone sensitive","mHSPC","mCSPC","HSPC","hormone-naive","hormone-refractory","biochemical recurrence","PSA recurrence","rising PSA","PSA progression","rPFS","hormone-relapsed","hormone-relapsed metastatic prostate cancer","hormone relapsed metastatic prostate cancer"],"tldr":"Prostate cancer starts out fed by testosterone (hormone-sensitive) and shrinks when it is removed. When it learns to grow despite castrate testosterone levels it is called castration-resistant, a later and more dangerous stage with its own treatments.","summary":"Metastatic hormone-sensitive disease (mHSPC) is treated with androgen deprivation plus an ARPI (abiraterone, enzalutamide, apalutamide, darolutamide) and sometimes docetaxel (STAMPEDE, LATITUDE, ARASENS), which delays castration resistance by years. Castration-resistant disease (CRPC), defined by PSA or radiographic progression with testosterone <50 ng/dL, arises through androgen receptor amplification, mutations, splice variants (AR-V7) and intratumoural androgen synthesis; it is treated with ARPI switch, docetaxel and cabazitaxel, PARP inhibitors for HRR mutations, 177Lu-PSMA-617 (VISION, PSMAfore) and radium-223. Non-metastatic CRPC (rising PSA, clear scans) has its own approvals. Radiographic PFS (rPFS) is the usual endpoint.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Prostate_cancer#Castration-resistant_prostate_cancer","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Prostate_cancer#Castration-resistant_prostate_cancer"}],"tags":[],"related":["castration-resistance","adt","arpi","endocrine-resistance"],"cancers":["prostate"],"sections":["hormonal"],"technologies":[],"targets":["androgen-receptor"],"drugs":["abiraterone","enzalutamide"],"companies":[],"institutions":[],"pathways":[],"terms":["tnm-prostate-cancer"],"trials":["stampede","latitude","vision","psmafore"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/mcrpc-mhspc/","neighbours":{"term":[{"id":"adt","kind":"term","name":"Androgen deprivation therapy (ADT)","route":"/terms/adt/"},{"id":"arpi","kind":"term","name":"Androgen receptor pathway inhibitor (ARPI)","route":"/terms/arpi/"},{"id":"castration-resistance","kind":"term","name":"Castration-resistant prostate cancer (CRPC)","route":"/terms/castration-resistance/"},{"id":"disease-volume-chaarted","kind":"term","name":"Disease volume (CHAARTED high-volume versus low-volume) and LATITUDE risk","route":"/terms/disease-volume-chaarted/"},{"id":"endocrine-resistance","kind":"term","name":"Endocrine resistance","route":"/terms/endocrine-resistance/"},{"id":"prostate-stampede-arms","kind":"term","name":"STAMPEDE's arms, and what each one answered","route":"/terms/prostate-stampede-arms/"},{"id":"tnm-prostate-cancer","kind":"term","name":"TNM staging for prostate cancer, and what changed in the 9th edition","route":"/terms/tnm-prostate-cancer/"},{"id":"prostate-crpc-sequencing","kind":"term","name":"What follows what in castration-resistant prostate cancer","route":"/terms/prostate-crpc-sequencing/"}],"cancer":[{"id":"prostate-nmcrpc","kind":"cancer","name":"Non-metastatic castration-resistant prostate cancer","route":"/cancers/prostate-nmcrpc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"hormonal","kind":"section","name":"Hormonal Therapy","route":"/fronts/hormonal/"}],"target":[{"id":"androgen-receptor","kind":"target","name":"Androgen receptor","route":"/targets/androgen-receptor/"},{"id":"cyp17a1","kind":"target","name":"CYP17A1 (17-alpha-hydroxylase/17,20-lyase)","route":"/targets/cyp17a1/"}],"drug":[{"id":"abiraterone","kind":"drug","name":"Abiraterone acetate","route":"/drugs/abiraterone/"},{"id":"apalutamide","kind":"drug","name":"Apalutamide","route":"/drugs/apalutamide/"},{"id":"darolutamide","kind":"drug","name":"Darolutamide","route":"/drugs/darolutamide/"},{"id":"enzalutamide","kind":"drug","name":"Enzalutamide","route":"/drugs/enzalutamide/"}],"trial":[{"id":"getug-afu-15","kind":"trial","name":"GETUG-AFU 15","route":"/trials/getug-afu-15/"},{"id":"keynote-991","kind":"trial","name":"KEYNOTE-991","route":"/trials/keynote-991/"},{"id":"latitude","kind":"trial","name":"LATITUDE","route":"/trials/latitude/"},{"id":"psmafore","kind":"trial","name":"PSMAfore","route":"/trials/psmafore/"},{"id":"stampede","kind":"trial","name":"STAMPEDE","route":"/trials/stampede/"},{"id":"tax-327","kind":"trial","name":"TAX 327","route":"/trials/tax-327/"},{"id":"tropic","kind":"trial","name":"TROPIC","route":"/trials/tropic/"},{"id":"vision","kind":"trial","name":"VISION","route":"/trials/vision/"}],"paper":[{"id":"paper-stopsack-mcspc-genomic-alterations-outcomes-ccr-2020","kind":"paper","name":"Oncogenic genomic alterations, clinical phenotypes and outcomes in metastatic castration-sensitive prostate cancer","route":"/key-papers/paper-stopsack-mcspc-genomic-alterations-outcomes-ccr-2020/"}],"biomarker":[{"id":"spop-mutation","kind":"biomarker","name":"SPOP mutation","route":"/biomarkers/spop-mutation/"}]}}