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GU Cancers 2026 | De-escalation strategies to reduce ADT and ARPI burden in prostate cancer

Umang Swami, MD, MS, University of Utah, Salt Lake City, UT, comments on the potential benefits of de-escalation therapy in prostate cancer, which may lead to a reduction in androgen deprivation therapy and the use of ARPIs, resulting in improved quality of life and decreased financial toxicity for patients. This approach may also lead to reduced fatigue, better sexual function, and improved cardiovascular and bone health outcomes, as well as fewer side effects such as hot flashes. This interview took place at the 2026 ASCO GU Cancers Symposium in San Francisco, CA.

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Transcript

So right now these studies are under investigation but we are hopeful that a de-escalation therapy will mean patients will need less androgen deprivation therapy, less use of ARPIs which will result in a subsequent improvement in quality of life as well as decrease in financial toxicity. They will have less fatigue, they may have better sexual function, they may have better cardiovascular outcomes and they may preserve their bone health, muscle mass and may have less side effects such as fatigue and hot flashes...

So right now these studies are under investigation but we are hopeful that a de-escalation therapy will mean patients will need less androgen deprivation therapy, less use of ARPIs which will result in a subsequent improvement in quality of life as well as decrease in financial toxicity. They will have less fatigue, they may have better sexual function, they may have better cardiovascular outcomes and they may preserve their bone health, muscle mass and may have less side effects such as fatigue and hot flashes. So that’s what our belief is. And for this study, we are doing ecological momentary assessments, as well as various patient-related outcomes. And we are hopeful that in the next few years, we will be presenting these results for the patients and other caregivers.

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