Page 32 - PACE: Advanced Prostate Cancer Consensus

How should Glen
Patient Progresses to mCRPC be treated?

Glen is now 71 years old

Diagnosis and Treatment History

Summer 2009 Fall 2013 Spring 2020 Fall 2022

Diagnosed with localized Biochemical failure after PSA progression at age Radiographic
prostate cancer at age 58: local therapy at age 62: 69: progression

• PSA 9.5 ng/mL • PSA 10.4 ng/mL • September 2019 PSA = 0.7 • Admitted to
• Gleason 7 (3 + 4) • Begins intermittent ADT ng/mL hospital with

• Radical prostatectomy with (leuprolide) • April 2020 PSA = 2.9 ng/mL back pain
pelvic lymph node dissection • PSA drops to undetectable • September 2019 to April • Imaging revealed

• Results: T3a, N0, M0 levels 2020, PSADT = 3.4 months multiple lumbar
• Post-operative PSA: 0.05 ng/mL • T = 0.5 nmol/L • T = 0.5 nmol/L vertebral lesions
• T = 13.2 nmol/L • Negative on conventional
imaging (CT and bone scan)
• Started on apalutamide or

Patient case is a hypothetical example enzalutamide