Ryan (67 years old)

Ryan, 67 years old, used to work at an interior design store. He loves the look and feel of expensive furniture, but could never afford it. He was diagnosed with high-volume, high-risk mHSPC 2 years ago (PSA 456 ng/ml, multiple bone metastases) and treatment with ADT + docetaxel + darolutamide was started (within clinical trial). After 6 cycles, his PSA dropped to 5 ng/ml.

Current situation, 1.5 years after stopping docetaxel, treatment with darolutamide still ongoing:

• No comorbidities
• Family history:
  • Father died of PCa at age of 64 years
  • Brother diagnosed with high-risk PCa at age of 61 years
• Germline testing: BRCA2 carrier
• ECOG PS: 0
• Asymptomatic
• Rising PSA: 40 ng/ml
• Testosterone: 17 ng/dl (0.59 nmol/l)
• CT and bone scan: pelvic and retroperitoneal LNs (all <3 cm), progression of bone metastases