Anthony (58 years old)

Anthony, a 58-year-old police officer, was diagnosed with multiple bone metastatic PCa (PSA 385 ng/ml) almost 3 years ago. He has no major comorbidities.

Course of the disease:

• Treatment with ADT + 6 cycles of docetaxel. His PSA 6 months after starting chemohormonal therapy was 2.1 ng/ml, ALP 31 U/l
• At 24 months post-ADT initiation:
  • Increase in PSA to 24 ng/ml in 8 months
  • Castrate testosterone level
  • Bone scan: progression of bone metastases
  • CT scan: 1 visceral metastasis (lung)
  • Bone pain: requires paracetamol
  • ECOG PS: 1
• Treatment for mCRPC was started with abiraterone:
  • PSA: 4.1 ng/ml
  • Bone metastases shrank by 20% (RECIST)
• Now, 9 months after starting abiraterone:
  • PSA: 20 ng/ml, ALP: 185 U/l
  • CT scan: radiographic progression of lymph nodes and lung metastasis (new)
  • ECOG PS: 1
  • No germline and/or somatic BRCA1/2 mutation identified