For a patient with metastatic castration-resistant prostate cancer to the bones with rising PSA but no evidence of radiographic or symptomatic progression, would you continue with the same treatment or change therapy based on biochemical progression?

This question emphasizes the importance of radiographic monitoring while on treatment for mCRPC. In a recent study from the PREVAIL trial of enzalutamide in chemo naive men with mCRPC, we found that radiographic progression occurred in about 1 out of 4 men (25%) without evidence of formal PSA progre...