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Prostate Cancer — SCE Medical Oncology MCQ

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HardUrological CancersProstate CancerSCE Medical Oncology

A patient has untreated metastatic castration-resistant prostate cancer with minimal symptoms. Chemotherapy is not clinically indicated. Severe steroid-induced psychosis makes abiraterone-prednisolone unsuitable, and there is no contraindication to enzalutamide. Which newly recommended NICE option can be considered without requiring an HRR mutation?

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Correct answer: C — Talazoparib with enzalutamide under the TA1130 commercial arrangements

TA1130 recommends talazoparib with enzalutamide for untreated hormone-relapsed metastatic prostate cancer when chemotherapy is not clinically indicated and abiraterone-prednisolone is not tolerated or is precluded by clinical conditions. The final NICE recommendation is not restricted to HRR-mutated cancer. Talazoparib is not used alone, abiraterone retains the steroid problem, and cabazitaxel or radium-223 do not match this defined first-line population.

Reference: NICE TA1130 talazoparib with enzalutamide for untreated hormone-relapsed metastatic prostate cancer (Published February 2026): https://www.nice.org.uk/guidance/TA1130/chapter/1-recommendations