Case 1: Vicente

Vicente, 70 years old, was diagnosed with high-volume metastatic prostate cancer (PCa) 4 years ago:

• Bone and CT scan: 5 bone metastases (3 on vertebrae, 1 on the pelvis, 1 on a rib), no visceral metastases
• Treatment with ADT + docetaxel was started
• Good biochemical and radiographic response (PSA of 56 ng/ml dropped to a nadir value of 2.3 ng/ml)

Current situation, 3 years after completing 6 cycles of docetaxel. Vicente is now diagnosed with mCRPC.

• Medical history: well-controlled hypertension
• Asymptomatic
• ECOG PS: 0
• Serum testosterone: 20 ng/ml (0.7 nmol/L)
• PSA: 21 ng/ml
• Bone and CT scan: progression of existing bone metastases and 4 new bone metastases (2 on vertebrae, 1 on the pelvis, 1 on the left femur) that were not present on scans 6 months ago, no visceral metastases
• No actionable germline or somatic mutations identified