Metastatic Castration-Resistant Prostate Cancer | Evidence in Action Series

Dr Pedro Barata discusses the following case on G-Med:

A 64-year-old man with prostate adenocarcinoma (Gleason 4+4) underwent prostatectomy 8 years ago. He developed biochemical recurrence (BCR) 3 years later and was started on continuous androgen deprivation therapy (ADT). PSA remained stable for 3 years but recently began rising again (doubling time: 5 months). Restaging with bone scan shows new osseous metastases; CT CAP shows no visceral disease. Serum testosterone is castrate. He is asymptomatic with good performance status. Germline testing reveals a pathogenic BRCA1 mutation. He now meets criteria for metastatic castration-resistant prostate cancer (mCRPC).

Discussion Questions:
How does BRCA1 status influence the treatment choice?
How does one prioritize efficacy (rPFS, OS) vs. toxicity (hematologic, bone marrow)?
When is radiopharmaceutical therapy preferred over PARP inhibitors?

Poll: What is your preferred treatment at this time?
Enzalutamide + Radium-223
Enzalutamide + Talazoparib
Abiraterone + Olaparib
Abiraterone + Niraparib
ARPI alone: enzalutamide or abiraterone monotherapy

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Evidence in Action is a G-Med series featuring real-world clinical cases developed with leading medical experts. Each case highlights current guidelines and research to spark discussion and peer-to-peer learning across specialties.

Видео Metastatic Castration-Resistant Prostate Cancer | Evidence in Action Series канала G-Med Physicians