Dr. Calais explains the utility of PSMA PET prior to RT for unfavorable intermediate-risk or high-risk prostate cancer. Radical prostatectomy resulted in worse urinary incontinence for patients with localized prostate cancer. Dr. Eggener describes the Stockholm3 test and reasons for validating it in an ethnically-diverse population. No G3 or G4 GU or GI toxicities occurred in either treatment arm, and G2 toxicities were uncommon. Drs. Freedland and Wallis continue their EMBARK discussions and recommendations for treating high-risk BCR prostate cancer. Drs. Freedland and Wallis discuss the details of the NEJM phase 3 EMBARK study on enzalutamide in BCR prostate cancer. Enzalutamide plus leuprolide and enzalutamide monotherapy resulted in significantly MFS and a longer time to PSA progression. Drs. George and Wallis discuss applications and counseling patients on focal therapy, as well as post-treatment follow-up. Enzalutamide plus leuprolide acetate and enzalutamide alone caused delayed MFS when compared with placebo plus leuprolide. The FDA approved enzalutamide as the first AR-signaling inhibitor for the treatment of nmCSPC with high-risk BCR. PCSM was found to be lower after local therapy use in patients with higher-risk disease, particularly after RP. Clarity announced that 50 patients have now been imaged with 64Cu-SAR-Bombesin in its US-based diagnostic trial. The trio highlights the results of a study on whether bone scans overstage PC compared with PSMA PET at initial staging. A background on PSMA PET scans for staging of prostate cancer and comparison of accuracy of conventional vs PSMA PET imaging. Enzalutamide combined with leuprolide led to higher rates of MFS than leuprolide alone. ArteraAI Prostate—a multimodal, AI-derived prognostic test—was successfully validated in the phase 3 STAMPEDE trials. New understandings of PROs related to enzalutamide-plus-leuprolide-acetate treatment for high-risk BCR nmHSPC. According to new data, concerns surrounding the efficacy of 19-20 Gy single-dose HDR-BT as a monotherapy may be unfounded. While the low-dose arm required more salvage therapy, dose-escalated RT resulted in lower rates of DM. Blinded, independent review revealed MFS insights for patients who received radiotherapy before treatment for BCR PC.