Thorben (72 years old)

Thorben, 72 years old, is a member of the local fishing club and loves to spend his Sunday afternoon at the fishing pond. Lately it was painful to sit for such a long time. It turned out his disease progressed in the bone.

He was diagnosed with high-risk PCa 9 years ago (pT3aN0, ISUP grade 4, postoperative PSA <0.1 ng/ml). 2 years after diagnosis he began ADT alone for metastatic relapse in the bones. The disease progressed to mCRPC 5 years ago. He received enzalutamide as first-line and 6 cycles docetaxel as second-line therapy.

Follow-up today (4 months after stopping docetaxel):

• No comorbidities
• No relevant family history
• ECOG PS: 1
• Fairly well controlled pain (VAS score 3)
• Rising PSA: 110 ng/ml
• PSMA-PET/CT: progression in bone only (all lesions PSMA positive and higher PSMA expression than liver)
• No germline and/or somatic HRR/BRCA mutation identified