Case 3: Samuel

Samuel, 81 years old, was recently diagnosed with mHSPC.

Medical history: angina pectoris and well-controlled hypertension, receiving a beta blocker (bisoprolol), a statin (atorvastatin) and an ACE inhibitor (lisinopril)
ECOG PS: 1
PSA: 56 ng/ml
Prostate biopsy: ISUP grade group 4 (Gleason score 4+4)
Bone scan: 6 metastases (3 in the spine, 2 in the right hip and 1 in a rib)
CT: locally advanced prostatic mass, few enlarged pelvic lymph nodes, no visceral metastases
No actionable germline or somatic mutations detected

He will start treatment with ADT.

ADT + 6 cycles of docetaxel

ADT + abiraterone/prednisone

ADT + apalutamide

ADT + darolutamide

ADT + enzalutamide

ADT + 6 cycles of docetaxel 75 mg/m² q3w + abiraterone/prednisone or darolutamide

ADT + 6 cycles of docetaxel 50 mg/m² q2w + darolutamide