Case 2: A 63-Year-Old Man With Recurrent HSPC

EP: 1.A 69-Year-Old Man With Metastatic Hormone Sensitive Prostate Cancer

EP: 2.Abiraterone Acetate: Generic and Branded Options

EP: 3.Formulations, Food, and Frequency: Optimizing Absorption and Tolerability in Daily Practice

EP: 4.BRCA Mutations in mHSPC: Impact on Therapy Selection

EP: 5.Comorbidities and Adherence: Tailoring mHSPC Treatment

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EP: 6.Case 2: A 63-Year-Old Man With Recurrent HSPC

EP: 7.Treatment Strategies for Symptomatic Bone Metastases in mHSPC

EP: 8.Targeted Therapy in mHSPC: Effects of Mutation Absence

EP: 9.First-Line mHSPC Therapy: AR Inhibitors vs Chemotherapy

EP: 10.The Role of Bone-Targeted Therapies

Clinical Brief: Case Presentation of Recurrent Hormone-Sensitive Prostate Cancer

Main Discussion Topics

• Patient Profile: 63-year-old Black man with urinary retention, fatigue, and poor appetite
• Initial Presentation: PSA of 138 ng/mL, Gleason score 8 adenocarcinoma, initially negative for metastases
• Disease Progression: Post-prostatectomy PSA decline to 0.2 ng/mL, followed by rise to 90 ng/mL after 1 year
• Advanced Disease Features: Multiple metastatic bone lesions and diffuse liver lesions, negative genetic testing

Key Points for Physicians

• Gleason score 8 (Grade Group 4) considered high risk, associated with aggressive disease behavior
• PSMA PET/CT recommended over conventional imaging in high-risk patients due to superior sensitivity and specificity
• Significantly elevated initial PSA (138 ng/mL) suggests high likelihood of metastatic disease
• Treatment strategy determination requires accurate staging with consideration of tumor volume and metastatic burden

Notable Insights

The presenter emphasizes the importance of using advanced imaging techniques like PSMA PET/CT for accurate staging in high-risk cases, which can significantly impact treatment planning and prognostication.

Clinical Significance

Accurate disease characterization through appropriate imaging and biomarker assessment is essential for determining optimal treatment strategies and defining prognosis in recurrent prostate cancer.