Options mapped

Prostate cancer: options by country

Sourced options by country plus visit-prep questions for Prostate cancer. Each line links to its regulator, HTA, or guideline source. This page maps options; it does not recommend or rank them.

Options mappedSolid tumorLast checked June 2026

What this page does

Maps options by country

It maps sourced options by country alongside diagnosis wording, stage, test results, specialists, and trial-search terms.

What it does not do

Does not choose treatment

It does not rank treatments, recommend a choice, or decide clinical fit.

Where it comes from

Built on trusted sources

Every option links to a trusted regulator, HTA, or guideline source, and the list grows as new sources pass verification.

Information to gather before the next visit

What is the risk group and stage?
Is active surveillance or watchful waiting appropriate for this pathology and PSA pattern?
What monitoring schedule and triggers for treatment would be used?
Is the cancer localized or locally advanced in a way that surgery is being considered?

Trial-search terms to discuss

Prostate cancer clinical trial

Options by country

Treatments by country

Regulatory and access status by country, from official sources. It shows what exists and where — not a recommendation.

United States

darolutamide (Nubeqa)[1]Approvedno required molecular biomarker; non-metastatic castration-resistant prostate cancer; adult non-metastatic castration-resistant prostate cancer in the United States. · The current label confirms broader active U.S. indications, but this finding is limited to the nmCRPC setting and does not establish reimbursement or comparative positioning versus enzalutamide/apalutamide. Dose reductions are specified for severe renal impairment not on hemodialysis and moderate hepatic impairment. Confidence/conflicts: High for current U.S. label scope including nmCRPC; no source conflict identified.
enzalutamide (Xtandi)[2]Approvedno required molecular biomarker; non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis; non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis in the United States. · The label verifies the U.S. indication and GnRH wording but does not establish payer coverage, sequencing preference against salvage local therapy, or individual candidacy. Seizure, falls/fractures, cardiovascular, and swallowing-size warnings remain material label considerations. Confidence/conflicts: High for current U.S. label indication and administration framing; no source conflict identified.
external-beam radiation therapy, interstitial implantation of radioisotopes/brachytherapy, and palliative radiation therapy in metastatic symptom contexts [3]Standard option (per NCI PDQ)not biomarker-specific; stage I-III localized/locally advanced options and stage IV palliative symptom-control contexts. · Radiation type and intent vary by stage and goals of care. Palliative radiation for symptoms is distinct from definitive radiation for localized disease. Confidence/conflicts: high for NCI PDQ modality listing; no conflict identified.
hormonal manipulations / androgen-deprivation approaches [3]Standard option (per NCI PDQ)not biomarker-specific; stage III with or without radiation; stage IV disease. · Hormonal therapy is not chemotherapy, but this queue category is used here for systemic non-targeted medical therapy until a prostate-specific endocrine category exists. Choice of agent and combinations require oncology/urology review. Confidence/conflicts: high for NCI PDQ modality support; category mapping caveat noted. No conflict identified.
lutetium Lu 177 vipivotide tetraxetan (Pluvicto)[4]FDA-approvedPSMA-positive disease by appropriate imaging/selection pathway; PSMA-positive mCRPC after androgen receptor pathway inhibitor therapy, when delaying taxane-based chemotherapy is considered appropriate. · This is a radioligand therapy label indication. PSMA positivity, prior therapy, marrow/renal status, radiation-safety logistics, and center capability require specialist review. Confidence/conflicts: high for FDA label; no conflict identified.
lutetium Lu 177 vipivotide tetraxetan (Pluvicto)[5]Approvedprostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer; PSMA-positive metastatic castration-resistant prostate cancer after ARPI therapy, either pre-taxane-delay or post-taxane, in the United States. · The legacy 2022 FDA approval page for the original post-taxane indication currently resolves to an FDA page-not-found state, so this finding is anchored to the current DailyMed label rather than the retired page. Radioligand-specific safety issues include radiation exposure precautions, myelosuppression, renal toxicity, embryo-fetal toxicity, and infertility risk. Confidence/conflicts: High for the current U.S. label and 2025 FDA expansion; historical 2022 FDA approval-page link rot noted, but no conflict on current indication.
niraparib + abiraterone acetate + prednisone (Akeega + prednisone)[6]FDA-approvedBRCA-mutated metastatic castration-resistant prostate cancer; adult BRCA-mutated metastatic castration-resistant prostate cancer in the United States. · The current AKEEGA label also includes a newer BRCA2-mutated mCSPC indication, but this finding is limited to the mCRPC setting captured in the earlier draft prostate batch. Label warnings and monitoring needs include myelosuppression, hypertension, hypokalemia, hepatotoxicity, and corticosteroid-associated issues. Confidence/conflicts: High for FDA approval and current U.S. label status; no source conflict identified.
niraparib and abiraterone acetate (Akeega) plus prednisone [7]FDA-approveddeleterious or suspected deleterious BRCA mutation by FDA-approved test; adult BRCA-mutated metastatic castration-resistant prostate cancer. · Biomarker confirmation is required in the FDA notice. The source does not rank this option against other PARP/androgen-axis combinations. Confidence/conflicts: high for FDA approval notice; no conflict identified.
olaparib (Lynparza) with abiraterone and prednisone or prednisolone [8]FDA-approveddeleterious or suspected deleterious BRCA mutation by FDA-approved companion diagnostic; adult BRCA-mutated metastatic castration-resistant prostate cancer. · Biomarker confirmation with an FDA-approved companion diagnostic is part of the FDA statement. This does not imply suitability for people without BRCA-mutated mCRPC or without access to the companion diagnostic. Confidence/conflicts: high for FDA approval notice; no conflict identified.
radical prostatectomy [3]Standard option (per NCI PDQ)not biomarker-specific; stage I-III prostate cancer contexts. · Surgical appropriateness depends on stage/risk, anatomy, health status, goals, and multidisciplinary evaluation. NCI PDQ listing is not patient-specific eligibility. Confidence/conflicts: high for NCI PDQ modality listing; no conflict identified.
talazoparib + enzalutamide (Talzenna + Xtandi)[9]FDA-approvedhomologous recombination repair gene-mutated metastatic castration-resistant prostate cancer; adult HRR gene-mutated metastatic castration-resistant prostate cancer in the United States. · The FDA approval page summarizes TALAPRO-2 and notes prior systemic therapy for mCRPC was excluded, though prior CYP17 inhibitors or docetaxel for mCSPC were permitted. The TALZENNA label carries major hematologic toxicity and MDS/AML warnings, so this is not a generic PARP option for all-comers. Confidence/conflicts: High for FDA approval and current label wording; no source conflict identified.
watchful waiting or active surveillance / active monitoring [3]Standard option (per NCI PDQ)not biomarker-specific; localized stage I-III prostate cancer contexts as listed by NCI PDQ. · Monitoring approaches depend on risk group, life expectancy, symptoms, pathology, PSA kinetics, imaging, and patient preferences. This is an option to discuss, not a recommendation to defer treatment. Confidence/conflicts: high for NCI PDQ modality listing; no conflict identified.

European Union

lutetium (177Lu) vipivotide tetraxetan (Pluvicto)[10]EMA authorisedPSMA-positive prostate cancer; progressive PSMA-positive mCRPC after androgen-receptor pathway inhibition and taxane-based chemotherapy in the established EU indication. · EMA central authorisation does not establish national availability. The 2026 withdrawn variation means earlier pre-taxane expansion should not be inferred from the EU label. Confidence/conflicts: high for established EU indication and withdrawn-variation caveat; no conflict identified.
lutetium (177Lu) vipivotide tetraxetan (Pluvicto)[11]G-BA benefit assessmentPSMA-positive disease; progressive PSMA-positive mCRPC after AR pathway inhibition and taxane-based chemotherapy. · G-BA English text is a courtesy translation; the German original is legally binding. Benefit-assessment language is not an individual access decision. Confidence/conflicts: high for G-BA/IQWiG indication support; German original legally binding. No conflict identified.
lutetium (177Lu) vipivotide tetraxetan (Pluvicto) with androgen-deprivation therapy, with or without androgen receptor pathway inhibition [12]HAS reimbursement opinionPSMA-positive disease; third-line progressive PSMA-positive mCRPC after AR pathway inhibition and taxane-based chemotherapy. · HAS reimbursement opinion does not establish individual eligibility, radioligand-center capacity, or access outside the specified pathway. Confidence/conflicts: high for HAS opinion; no conflict identified.
niraparib and abiraterone acetate (Akeega) with prednisone or prednisolone, with androgen-deprivation therapy in the mHSPC indication [13]EMA authorisedBRCA1/2 mutations, germline and/or somatic; metastatic hormone-sensitive prostate cancer with BRCA1/2 mutations; metastatic castration-resistant prostate cancer with BRCA1/2 mutations when chemotherapy is not clinically indicated. · EMA central authorisation does not establish national reimbursement, access, or preference over other PARP/androgen-axis approaches. Biomarker confirmation is required. Confidence/conflicts: high for EMA authorised indications; no conflict identified.
niraparib/abiraterone acetate (Akeega) with prednisone or prednisolone [14]HAS reimbursement opinionBRCA1/2 mutations, germline and/or somatic; mCRPC with BRCA1/2 mutations when chemotherapy is not clinically indicated. · HAS notes the place of Akeega relative to olaparib plus abiraterone cannot be specified without comparative data, and reminds clinicians about serious hematologic risk monitoring. This is not a personalized recommendation. Confidence/conflicts: high for HAS opinion; no conflict identified.
olaparib (Lynparza) monotherapy [15]EMA authorisedBRCA1/2 mutation, germline and/or somatic; after progression following prior therapy that included a new hormonal agent. · EMA central authorisation does not establish reimbursement or access in each member state. BRCA1/2 mutation confirmation and prior-treatment history are essential. Confidence/conflicts: high for EMA authorised indication; no conflict identified.
olaparib (Lynparza) with abiraterone and prednisone or prednisolone [15]EMA authorisedno biomarker restriction stated in the EMA indication for this combination; mCRPC when chemotherapy is not clinically indicated. · Central authorisation does not determine national reimbursement. The source does not rank this combination against other androgen-axis or PARP options. Confidence/conflicts: high for EMA authorised indication; no conflict identified.

United Kingdom

active surveillance [16]NICE recommendednot biomarker-specific; CPG 1-3 localised prostate cancer contexts with restrictions by risk group. · Active surveillance is risk-stratified and not recommended by NICE for CPG 4-5. This entry does not imply suitability for an individual patient. Confidence/conflicts: high for NICE recommendation text; no conflict identified.
hormone therapy, chemotherapy when spread, supportive symptom care as part of specialist team management [17]Standard option (per NHS)not biomarker-specific; broad treatment/supportive context; chemotherapy if cancer has spread. · NHS public information is broad and not a treatment-selection guideline. It should be paired with NICE, oncologist/urologist, and local pathway details. Confidence/conflicts: medium-high; source is authoritative public information but broad. No conflict identified.
lutetium-177 vipivotide tetraxetan (Pluvicto)[18]NICE recommendedPSMA-positive disease; after 2 or more treatments including an AR pathway inhibitor and taxane-based chemotherapy. · Recommendation depends on PSMA positivity, prior-treatment sequence, and the commercial arrangement. It does not establish access in every UK setting or suitability for pre-taxane use. Confidence/conflicts: high for NICE recommendation; no conflict identified.
olaparib (Lynparza) with abiraterone and prednisone or prednisolone [19]NICE recommendedno BRCA requirement stated by NICE recommendation; untreated hormone-relapsed metastatic prostate cancer. · NICE appraisal applies to the NHS England context and does not determine devolved/private access. The recommendation is for the specified untreated hormone-relapsed metastatic setting. Confidence/conflicts: high for NICE recommendation; no conflict identified.
radical prostatectomy or radical radiotherapy [16]NICE recommendednot biomarker-specific; CPG 3 localised; CPG 4-5 localised and locally advanced prostate cancer when long-term control is likely. · Category is recorded as surgery because radical prostatectomy is one option, but the same NICE cell also supports radical radiotherapy. Choice depends on risk group, anatomy, comorbidity, and patient preferences. Confidence/conflicts: high for NICE recommendation text; no conflict identified.

Japan

olaparib (Lynparza) with abiraterone and prednisolone [20]PMDA-approved (Japan)BRCA-mutated; BRCA-mutated castration-resistant prostate cancer with distant metastasis. · Manufacturer announcement is MHLW-attributed but not the current Japanese package insert. Confirm current label, companion diagnostic requirements, reimbursement, and prednisolone wording locally. Confidence/conflicts: medium-high; combination-specific approval is source-backed by manufacturer/MHLW-attributed announcement, with primary-label follow-up needed. No conflict identified.

Russia

ADT with apalutamide, darolutamide, or enzalutamide [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; PSA doubling time is a clinical stratifier in source; nmCRPC stratified by PSA doubling time. · Guideline cell only. It does not establish drug registration, reimbursement, procurement, or local availability for each androgen receptor inhibitor. Confidence/conflicts: Medium-high for guideline role; regulator and reimbursement status source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Active surveillance, radical prostatectomy, external-beam radiation therapy, brachytherapy, androgen-deprivation therapy, and watchful waiting [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; cT1-4N0-1M0 non-metastatic prostate cancer risk-group management. · This is guideline evidence, not a guarantee of local access or a patient-specific choice. Russian-language clinical content requires human review before patient-facing reuse. Confidence/conflicts: Medium-high for guideline content; local institutional access and reimbursement not established. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Active surveillance, radical prostatectomy, external-beam radiation therapy, brachytherapy, androgen-deprivation therapy, and watchful waiting [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; cT1-4N0-1M0 non-metastatic prostate cancer risk-group management. · This is guideline evidence, not a guarantee of local access or a patient-specific choice. Russian-language clinical content requires human review before patient-facing reuse. Confidence/conflicts: Medium-high for guideline content; local institutional access and reimbursement not established. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Active surveillance, radical prostatectomy, external-beam radiation therapy, brachytherapy, androgen-deprivation therapy, and watchful waiting [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; cT1-4N0-1M0 non-metastatic prostate cancer risk-group management. · This is guideline evidence, not a guarantee of local access or a patient-specific choice. Russian-language clinical content requires human review before patient-facing reuse. Confidence/conflicts: Medium-high for guideline content; local institutional access and reimbursement not established. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Androgen-deprivation therapy (ADT) combined with apalutamide, enzalutamide, abiraterone plus prednisolone, docetaxel, darolutamide-docetaxel, or local radiation in selected low-burden primary-tumor contexts [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; Metastatic hormone-sensitive prostate cancer, stratified by metastatic burden and whether radical treatment of the primary tumor has been performed. · This entry records guideline options only; Russian product-label, reimbursement, and procurement status for each systemic therapy remain separate gaps. Confidence/conflicts: Medium-high for guideline role; regulator and reimbursement status source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Androgen-deprivation therapy (ADT) combined with apalutamide, enzalutamide, abiraterone plus prednisolone, docetaxel, darolutamide-docetaxel, or local radiation in selected low-burden primary-tumor contexts [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; Metastatic hormone-sensitive prostate cancer, stratified by metastatic burden and whether radical treatment of the primary tumor has been performed. · This entry records guideline options only; Russian product-label, reimbursement, and procurement status for each systemic therapy remain separate gaps. Confidence/conflicts: Medium-high for guideline role; regulator and reimbursement status source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Androgen-deprivation therapy (ADT) combined with apalutamide, enzalutamide, abiraterone plus prednisolone, docetaxel, darolutamide-docetaxel, or local radiation in selected low-burden primary-tumor contexts [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; Metastatic hormone-sensitive prostate cancer, stratified by metastatic burden and whether radical treatment of the primary tumor has been performed. · This entry records guideline options only; Russian product-label, reimbursement, and procurement status for each systemic therapy remain separate gaps. Confidence/conflicts: Medium-high for guideline role; regulator and reimbursement status source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Bone-modifying agents including bisphosphonates and denosumab; palliative treatment for symptomatic bone metastases including radiation and systemic radiopharmaceutical contexts [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; Bone-metastatic mCRPC and symptomatic bone metastasis contexts. · Supportive care depends on renal function, dental risk, calcium/vitamin D management, pain syndrome, fracture/spinal-cord-compression risk, and local radiation/radiopharmaceutical access. Confidence/conflicts: Medium-high for supportive guideline content; access and individualized need not inferred. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Bone-modifying agents including bisphosphonates and denosumab; palliative treatment for symptomatic bone metastases including radiation and systemic radiopharmaceutical contexts [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)Not biomarker-selected; Bone-metastatic mCRPC and symptomatic bone metastasis contexts. · Supportive care depends on renal function, dental risk, calcium/vitamin D management, pain syndrome, fracture/spinal-cord-compression risk, and local radiation/radiopharmaceutical access. Confidence/conflicts: Medium-high for supportive guideline content; access and individualized need not inferred. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Docetaxel, cabazitaxel, abiraterone plus prednisolone, enzalutamide, radium-223, PSMA-directed radioligand therapy (177Lu-PSMA), olaparib plus abiraterone, enzalutamide plus talazoparib, pembrolizumab in MSI-H context [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)HRR pathogenic mutations, especially BRCA1/2, and MSI-H status are molecular factors in source; Metastatic castration-resistant prostate cancer, with sequencing by prior ADT duration, prior docetaxel, prior androgen-signaling inhibitor, bone-only disease, HRR mutations, MSI-H, and neuroendocrine differentiation. · This entry is guideline-level and does not establish Russian approval, reimbursement, radiopharmaceutical availability, or local PSMA-PET access for each option. Confidence/conflicts: Medium-high for guideline role; product-specific regulator/reimbursement/access remains source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Docetaxel, cabazitaxel, abiraterone plus prednisolone, enzalutamide, radium-223, PSMA-directed radioligand therapy (177Lu-PSMA), olaparib plus abiraterone, enzalutamide plus talazoparib, pembrolizumab in MSI-H context [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)HRR pathogenic mutations, especially BRCA1/2, and MSI-H status are molecular factors in source; Metastatic castration-resistant prostate cancer, with sequencing by prior ADT duration, prior docetaxel, prior androgen-signaling inhibitor, bone-only disease, HRR mutations, MSI-H, and neuroendocrine differentiation. · This entry is guideline-level and does not establish Russian approval, reimbursement, radiopharmaceutical availability, or local PSMA-PET access for each option. Confidence/conflicts: Medium-high for guideline role; product-specific regulator/reimbursement/access remains source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Docetaxel, cabazitaxel, abiraterone plus prednisolone, enzalutamide, radium-223, PSMA-directed radioligand therapy (177Lu-PSMA), olaparib plus abiraterone, enzalutamide plus talazoparib, pembrolizumab in MSI-H context [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)HRR pathogenic mutations, especially BRCA1/2, and MSI-H status are molecular factors in source; Metastatic castration-resistant prostate cancer, with sequencing by prior ADT duration, prior docetaxel, prior androgen-signaling inhibitor, bone-only disease, HRR mutations, MSI-H, and neuroendocrine differentiation. · This entry is guideline-level and does not establish Russian approval, reimbursement, radiopharmaceutical availability, or local PSMA-PET access for each option. Confidence/conflicts: Medium-high for guideline role; product-specific regulator/reimbursement/access remains source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
Docetaxel, cabazitaxel, abiraterone plus prednisolone, enzalutamide, radium-223, PSMA-directed radioligand therapy (177Lu-PSMA), olaparib plus abiraterone, enzalutamide plus talazoparib, pembrolizumab in MSI-H context [21]Standard option (per Russian Society of Clinical Oncology / RosOncoWeb)HRR pathogenic mutations, especially BRCA1/2, and MSI-H status are molecular factors in source; Metastatic castration-resistant prostate cancer, with sequencing by prior ADT duration, prior docetaxel, prior androgen-signaling inhibitor, bone-only disease, HRR mutations, MSI-H, and neuroendocrine differentiation. · This entry is guideline-level and does not establish Russian approval, reimbursement, radiopharmaceutical availability, or local PSMA-PET access for each option. Confidence/conflicts: Medium-high for guideline role; product-specific regulator/reimbursement/access remains source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.

Thailand

Abiraterone acetate (Zytiga) with prednisone [22]ApprovedNot biomarker-selected; Metastatic CRPC; metastatic high-risk CSPC. · NDI document supports indication text but not reimbursement, formulary access, or center-level availability. The prescribing document states that GnRH analogue treatment should continue unless bilateral orchiectomy has been done. Confidence/conflicts: High for Thai NDI indication text; reimbursement not established.
Docetaxel with prednisone or prednisolone [23]ApprovedNot biomarker-selected; Metastatic prostate cancer resistant to hormonal/androgen-dependent control, as described in the Thai product document. · NDI document supports an approved chemotherapy indication, not a full treatment sequence or reimbursement guarantee. Toxicity monitoring, premedication, and fitness for chemotherapy require oncology assessment. Confidence/conflicts: High for Thai NDI indication text; reimbursement and sequencing not established. Primary source is in Thai. English summary pending human review — confirm exact wording with your care team.
Enzalutamide (Xtandi)[24]ApprovedNot biomarker-selected; mHSPC; high-risk nmCRPC; chemo-not-yet-indicated mCRPC after ADT; post-docetaxel mCRPC. · NDI prescribing document supports indication text and clinical-use conditions but not reimbursement, hospital formulary availability, or individual eligibility. Continued medical or surgical castration is described in the prescribing document. Confidence/conflicts: High for Thai NDI indication text; reimbursement not established. Primary source is in Thai. English summary pending human review — confirm exact wording with your care team.
Enzalutamide (Xtandi)[24]ApprovedNot biomarker-selected; mHSPC; high-risk nmCRPC; chemo-not-yet-indicated mCRPC after ADT; post-docetaxel mCRPC. · NDI prescribing document supports indication text and clinical-use conditions but not reimbursement, hospital formulary availability, or individual eligibility. Continued medical or surgical castration is described in the prescribing document. Confidence/conflicts: High for Thai NDI indication text; reimbursement not established. Primary source is in Thai. English summary pending human review — confirm exact wording with your care team.
Niraparib plus abiraterone acetate (Akeega) with prednisone or prednisolone [25]ApprovedBRCA1/2 mutation, germline or somatic; BRCA1/2-mutated mCRPC when chemotherapy is not clinically indicated. · Positive BRCA status must be established before treatment according to the prescribing document. NDI does not establish reimbursement, testing availability, or local access. Confidence/conflicts: High for Thai NDI indication text; reimbursement and BRCA testing access not established.
Olaparib (Lynparza) monotherapy or olaparib with abiraterone and prednisone/prednisolone [26]ApprovedHomologous recombination repair (HRR) gene mutations for olaparib monotherapy; no genomic testing required in the source for olaparib plus abiraterone/prednisone use; HRR-mutated mCRPC after prior new hormonal agent for monotherapy; mCRPC when chemotherapy is not clinically indicated for combination use. · NDI document supports indication text, mutation-testing requirements, and prescribing context but not reimbursement or local laboratory availability. HRR testing method and specimen type should be validated locally. Confidence/conflicts: High for Thai NDI indication text; reimbursement and validated local testing access not established.

Sources

DailyMed / U.S. National Library of Medicine — official U.S. drug label · official U.S. drug label
DailyMed / U.S. National Library of Medicine — official U.S. drug label · official U.S. drug label
National Cancer Institute (NCI) — national cancer agency evidence summary · national cancer agency evidence summary
U.S. Food and Drug Administration (FDA) — drug label / prescribing information · drug label / prescribing information
DailyMed / U.S. National Library of Medicine — official U.S. drug label · official U.S. drug label
DailyMed / U.S. National Library of Medicine — official U.S. drug label · official U.S. drug label
U.S. Food and Drug Administration (FDA) — regulator approval notice · regulator approval notice
U.S. Food and Drug Administration (FDA) — regulator approval notice · regulator approval notice
DailyMed / U.S. National Library of Medicine — official U.S. drug label · official U.S. drug label
European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
Institute for Quality and Efficiency in Health Care (IQWiG) — national HTA dossier assessment project page · national HTA dossier assessment project page
Haute Autorité de Santé (HAS) — national HTA/reimbursement opinion · national HTA/reimbursement opinion
European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
Haute Autorité de Santé (HAS) — national HTA/reimbursement opinion · national HTA/reimbursement opinion
European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
National Institute for Health and Care Excellence (NICE) — national guideline · national guideline
NHS — national health service patient information · national health service patient information
National Institute for Health and Care Excellence (NICE) — technology appraisal guidance · technology appraisal guidance
National Institute for Health and Care Excellence (NICE) — technology appraisal guidance · technology appraisal guidance
Pharmaceuticals and Medical Devices Agency (PMDA) — regulator review report / olaparib regulatory context · regulator review report / olaparib regulatory context
Russian Society of Clinical Oncology (RUSSCO) / RosOncoWeb — professional society clinical recommendations PDF · professional society clinical recommendations PDF
Thai National Drug Information / Thai FDA-MOPH — prescribing information PDF / regulator drug-information repository · prescribing information PDF / regulator drug-information repository
Thai National Drug Information / Thai FDA-MOPH — prescribing information PDF / regulator drug-information repository · prescribing information PDF / regulator drug-information repository
Thai National Drug Information / Thai FDA-MOPH — prescribing information PDF / regulator drug-information repository · prescribing information PDF / regulator drug-information repository
Thai National Drug Information / Thai FDA-MOPH — prescribing information PDF / regulator drug-information repository · prescribing information PDF / regulator drug-information repository
Thai National Drug Information / Thai FDA-MOPH — prescribing information PDF / regulator drug-information repository · prescribing information PDF / regulator drug-information repository

This is official regulatory and access status only — not medical advice, not a recommendation, and not a statement about eligibility. Whether any option fits depends on your situation and your oncology team. Status changes over time; confirm the current position with the linked source. Last checked 2026-06-12.

Beyond approved care

In clinical trials & emerging options

Options that are not — or not yet — an approved standard where you live: studies, clinical trials, off-label use, and early evidence that your own oncologist may not raise. Each is labeled by how strong the evidence is. A listing here is information to research and discuss with your team; it does not mean a treatment is proven, safe for you, or available today.

In clinical trials

lutetium (177Lu) vipivotide tetraxetan (Pluvicto)Clinical trial · NCT05114746Clinical trialTrial only (NCT05114746)Japan · PSMA-positive disease implied by Pluvicto study design; metastatic castration-resistant prostate cancer. · The registry language signals Japan approval/post-marketing transition but is not a PMDA label. Do not infer exact indication, reimbursement, or site access without Japanese regulator/package-insert verification. Confidence/conflicts: medium; registry supports Japan post-marketing-trial context but exact regulator indication remains a primary-source gap. No conflict identified. ClinicalTrials.gov — clinical-trial registry
177Lu-PSMA-617 with standard of care versus standard of care aloneClinical trial · NCT04720157Clinical trialTrial only (NCT04720157)Korea · not biomarker-specific; metastatic hormone-sensitive prostate cancer. · Trial is active-not-recruiting and investigational in this earlier disease setting; it does not establish MFDS approval or Korean reimbursement. Confidence/conflicts: high for registry status and site listing; no conflict identified. ClinicalTrials.gov — clinical-trial registry
mevrometostat (PF-06821497) plus enzalutamide versus enzalutamideClinical trial · NCT07028853Clinical trialTrial only (NCT07028853)Korea · ARPI-naive status per registry summary; metastatic castration-sensitive/hormone-sensitive prostate cancer in ARPI-naive participants. · Investigational trial-only record; not proof of MFDS approval, reimbursement, or individual eligibility. Confidence/conflicts: high for registry status and site listing; no conflict identified. ClinicalTrials.gov — clinical-trial registry
HRS-1167 tablets with abiraterone acetate tablets and prednisoneClinical trial · NCT06689163Clinical trialTrial only (NCT06689163)China · not biomarker-specific; metastatic prostate cancer. · Investigational trial-only record; it does not establish NMPA approval, reimbursement, or routine access. Confidence/conflicts: high for registry status and site listing; no conflict identified. ClinicalTrials.gov — clinical-trial registry
darolutamide (Nubeqa) plus androgen-deprivation therapy versus placebo plus androgen-deprivation therapyClinical trial · NCT04736199Clinical trialTrial only (NCT04736199)Russia · not biomarker-specific; metastatic hormone-sensitive prostate cancer. · Completed trial participation does not establish Russian regulatory approval, current availability, or reimbursement. Confidence/conflicts: high for registry status and site listing; no conflict identified. ClinicalTrials.gov — clinical-trial registry
opevesostat (MK-5684) versus alternative next-generation hormonal agent, with abiraterone acetate or enzalutamide comparators depending on study armClinical trial · NCT06136650Clinical trialTrial only (NCT06136650)Thailand · not biomarker-specific in fetched registry summary; metastatic castration-resistant prostate cancer post one next-generation hormonal agent. · Investigational, trial-only option; not proof of Thai approval, routine availability, or individual eligibility. Confidence/conflicts: high for registry status and site listing; no conflict identified. ClinicalTrials.gov — clinical-trial registry
saruparib versus placebo added to standard radiotherapy/androgen-deprivation therapy backbone, with abiraterone plus prednisolone/prednisone and ADT listed in the study interventionsClinical trial · NCT06952803Clinical trialTrial only (NCT06952803)Thailand · BRCA mutation; high-risk prostate cancer with BRCA mutation in standard RT/ADT context. · This is investigational trial access, not Thai FDA approval or reimbursement. Trial eligibility and site status must be confirmed with the study team. Confidence/conflicts: high for registry status and site listing; no conflict identified. ClinicalTrials.gov — clinical-trial registry

A clinical-trial listing or early report shows an option is being studied — not that it works, that it is safe for any one person, or that a site is enrolling today. Whether any of these fits is a conversation for your oncology team and the trial team. Last checked 2026-06-12.