Abiraterone, an androgen synthesis inhibitor, is used with caution by urologists because it needs to be given with prednisone, comments Kenneth Kernen, MD. Monitoring patients appropriately and counseling patients regarding the importance of compliance with oral therapy are important when using newer agents such as abiraterone, notes Kernen. Neal Shore, MD, adds that urologists were reluctant to use zoledronic acid when it was approved because it was administered intravenously. The team approach to the treatment of mCRPC has evolved along with the introduction of newer therapies, and Shore notes that healthcare providers, physician assistants, nurses, and administrative staff all play a role in the administration of newer drugs.

Philippa Cheetham, MD, discusses urologists’ fear of prescribing the androgen receptor inhibitor enzalutamide due to the risk of seizure; recent ASCO data have shown that the risk of seizure with enzalutamide is low. Michael Williams, MD, states that the best approach with newer agents is for everyone involved in patient care to be well trained and to work together as a team when treating patients with mCRPC.