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 nmCRPCand initiated onapalutamide(March 2022).
Patient
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
This is completed documentation.
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.
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