Prostate cancer
mCRPC: novel and emerging agents

Wilfred (69 years old)

Wilfred, 69 years old, regularly attends board game nights with his son. He was diagnosed with PCa 4 years ago.

  • Family history:
    • Father died of PCa at age of 90 years
    • Mother died of breast cancer at age of 67 years
  • Medical history:
    • 4 years ago: RT + 6 months of ADT for cT3 ISUP grade 3 (GS 4+3) PCa, PSA 21 ng/ml
    • 6 months after RT: PSA nadir 0.7 ng/ml
    • 2 years after RT: PSA 29 ng/ml, bone and CT scan: multiple bone lesions and retroperitoneal LNs. Treatment with ADT + enzalutamide started (PSA decreased to 0.3 ng/ml)
    • 3.5 years after RT: disease progression in pelvic/retroperitoneal LNs, PSA 102 ng/ml, testosterone 17 ng/dl. Treatment with docetaxel started
  • Current situation (4 years after RT)
    • ECOG PS: 1
    • Mild pelvic pain
    • CT and bone scan: progression in bone, pelvic and retroperitoneal LNs
    • Rising PSA: 110 ng/ml
    • Somatic BRCA2 mutation found in biopsy of primary tumour

Which of the following treatment options would you choose for this patient?