%I American Medical Association %L discovery10205615 %C United States %A Gianmarco Leone %A Francesco Orlando %A Peter Dutey-Magni %A Osvaldas Vainauskas %A Emily Grist %A Yari Ciani %A Sharanpreet Lall %A Suparna Thakali %A Anna Wingate %A Daniel Wetterskog %A Ashwin Sachdeva %A Matthew R Sydes %A Neil McPhail %A Thiagarajan Sreenivasan %A Joe M O'Sullivan %A Noel W Clarke %A Mahesh KB Parmar %A Louise C Brown %A Nicholas D James %A Francesca Demichelis %A Gerhardt Attard %A the STAMPEDE collaborators %T Plasma AR Alterations and Timing of Intensified Hormone Treatment for Prostate Cancer: the STAMPEDE Phase 3 Randomized Clinical Trial %J JAMA Oncology %X We previously reported that abiraterone acetate and prednisolone (hereafter abiraterone) added at initiation of androgen deprivation therapy (ADT) improved survival of metastatic and very high-risk locally advanced prostate cancer and that combining with enzalutamide did not change efficacy.1 Using next-generation sequencing on plasma DNA, we previously showed that genomic alterations of the androgen receptor (AR) gene contribute to resistance to abiraterone or enzalutamide when initiated for metastatic castration-resistant prostate cancer after progression with ADT alone.2 It is unknown whether hormone intensification at start of ADT alters selection of AR alterations within the gene body and/or enhancer region.3 %O This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. %D 2025