Case Based Peer Perspectives: Metastatic Castration-Resistant Prostate Cancer
Case Based Peer Perspectives: Metastatic Castration-Resistant Prostate Cancer
Case: A 69-Year-Old Man With mCRPC Progressing on Therapy
July 2016
H&P:
- A 69-year old gentleman presented with nocturia
- PMH: unremarkable
- DRE, enlarged prostate
- PSA, 50.3 ng/mL
- TRUS and biopsy showed adenocarcinoma of the prostate gland; Gleason score 8 [4+4]
- CT scan showed minimal nodal involvement
Treatment:
- Started on ADT with initial PSA response - 15 ng/ml August 2016
March 2017
8 months later, patient complained of fatigue and mild back discomfort
- Imaging with CT and bone scan showed two metastatic bone lesions (1 spine, 1 pelvis)
- PSA, 25 ng/mL
- Hb, 9.0 g/dL
- ANC, 1.7
Treatment:Enzalutamide
- Initial PSA response 10 mg/ml but rising over one year later continued
March 2018
- PSA 30 ng/ml
- CT showed 4 bone metastases (2 spine, 2 pelvis) and diffuse liver lesions
April 2018
- Radium-223 initiated, patient received 6 injections
April 2019
One year later patient presented with increased lower back discomfort causing disruption in daily activity.
- CT showed new lymphadenopathy and diffuse liver lesions
- PSA 45 ng/mL
- Hb, 9.0 g/dL
- ANC, 1.6
- Treatment: Patient started on docetaxel, 6 cycles completed; achieved stable disease (Hb, 14.1 g/dL)
BXCL701 Gains Fast Track Designation for mCRPC Treatment
February 13th 2024The FDA has granted fast track designation to BXCL701 with an immune checkpoint inhibitor for metastatic small cell neuroendocrine prostate cancer resistant to chemotherapy and showing no evidence of microsatellite instability.
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Study Sheds Light on Genetic Variations in Advanced Prostate Cancer
February 12th 2024In an interview with Targeted Oncology, Clara Hwang, MD, discussed the notable differences in molecular alterations observed in the retrospective cohort study among Black men with metastatic castration-resistant prostate cancer compared with White men.
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