Treatment Options for Patients With Prostate Cancer Who Develop Metastatic Disease After Hormonal Therapy

摘要

The patient is a 66-year-old man in good cardiovascular health. He has a family history of prostate cancer. He presents with fatigue and minor discomfort in his lower back. He had not undergone previous prostate-specific antigen (PSA) testing. His first PSA test shows an elevated level of 7 ng/mL Imaging reveals 3 bone metastases: 2 in the pelvis and 1 in the right posterior rib (Figure 1 A). He has no visceral disease. His Gleason score is 4+4. The patient is diagnosed with metastatic hormone-sensitive prostate cancer (mHSPC), and he begins treatment with abiraterone acetate (Zytiga, Janssen) plus prednisone. A dual X-ray absorptiometry (DEXA) scan reveals an index T-score of -1.5 in his femurs. Based on the moderate risk for fracture, he begins treatment with androgen deprivation therapy (ADT) plus zoledronic acid.