Prostate cancer
mCRPC: novel and emerging agentsCase 1: Walt (73 years old)
Walt, 73 years old, loves a good dinner with his wife and they often attend wine-tasting nights. He was diagnosed with PCa 7 years ago.
Medical history:
- 7 years ago: RP for PCa (pT3bN0, ISUP grade 5, postoperative PSA <0.1 ng/ml)
- 6 years ago: salvage RT for rising PSA (0.53 ng/ml)
- 5 years ago: ADT started because of rising PSA (7 ng/ml), no metastases on conventional imaging
- 2 years ago: progression to mCRPC (bone), treatment with abiraterone started
Current situation:
- Ongoing treatment with ADT + abiraterone
- Rising PSA: from 0.9 ng/ml to 3.9 ng/ml
- ECOG PS: 1
- Back pain
- MRI spine:
- Progression of existing bone lesions and new bone lesions in multiple vertebrae
- Enlarging soft tissue component at Th9 causing spinal cord compression
- Neurosurgical decompression was performed
- Histology from neurosurgical decompression: metastatic poorly-differentiated PCa
- Somatic BRCA2 mutation