Patient Profile Case 3

Case 3: 75 year-old male

Progression from nmCRPC to mCRPC

_{^{*Fictional patient and fictional personal information.}}

Patient history:

Patient received treatment for co-morbid hypertension and hyperlipidemia.
Referred to Medical Oncologist after rising PSA detected, with PSADT <6 months.
Patient diagnosed with nmCRPC and initiated on apalutamide (March 2022).

Patient did not proactively mention pain during GP visits but upon questioning he shared that he stopped golfing to avoid back pain. He is not currently on any analgesics. Reports some fatigue but maintains a functional ECOG of 0-1, indicating minimal impact on his daily walks.

Disease progression and Management timeline

Diagnosis and Work-up

Patient diagnosed with localized prostate cancer by Urologist in January 2020.
After radical prostatectomy, patient received ART and was initiated on ADT (April 2020).

Current Presentation

BMI: 21
ECOG Performance Status: 1
HRR gene panel: negative

Imaging Results (December 2024)

CT and bone scan: Detected multiple sub-centimeter lesions in the thoracic and lumbar spine.
Abdominal, chest and pelvic CT scans: Indicate no evidence of pelvic or para-aortic lymph node or visceral involvement.

What is the next step for managing this patient?

Progression from nmCRPC to mCRPC

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^{ADT=androgen deprivation therapy; CT=computed tomography; ECOG=Eastern Cooperative Oncology Group; HRR=homologous recombination repair; mCRPC=metastatic castration resistant prostate cancer;}
^{mCSPC=metastatic castration sensitive prostate cancer; PSA=prostate-specific antigen; PSADT=prostate-specific antigen doubling time.}
^{*Fictitious patient. May not be representative of all cases.}
^{© 2025, Bayer Inc.}