Reply to 'A mitochondrion‐centric approach to guide treatment de‐escalation in advanced prostate cancer' by Su et al.

The article discusses the potential of a mitochondrion-centric approach to guide treatment de-escalation in metastatic hormone-sensitive prostate cancer (mHSPC). It emphasizes the importance of preserving metabolic health during long-term systemic therapy, highlighting mitochondrial dysfunction as a significant factor in cancer progression and cardiovascular effects related to androgen-deprivation therapy (ADT). The authors note that while promising biomarkers, including genomic alterations and liquid biopsy technologies like circulating tumor DNA (ctDNA), are being investigated, the clinical translation of these findings is still in early stages. Additionally, they point out the emerging role of imaging, particularly PSMA-PET/CT, in monitoring treatment response and guiding de-escalation strategies, while advocating for a holistic and individualized approach to patient management. [Extracted from the article]