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Advanced Prostate Cancer
Center of Excellence
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Waleed Ragab
Apr 23, 2021
Enzalutamid
Kenneth Chen
Apr 23, 2021
The presence of a BRCA2 mutation tells us he would benefit from the PARPI, however indication is only in the mCRPC space. I would offer docetaxel for this patient based on the aggressive histology, high volume disease including viscera involvement and considering his good performance status.
Jose Luis Soto Rodriguez
Apr 23, 2021
docetaxel x6 cycles
Hadi Molana
Apr 23, 2021
Olaparib
Muho Ahmed
Apr 23, 2021
Olaparib
Rene Henriquez
Apr 23, 2021
Docetaxel 6cycles
Thomas Zahreddin
Apr 23, 2021
olaparib
Kazuyuki Sagiyama
Apr 23, 2021
Docetaxel 6cycles
Bahram Mofid
Apr 23, 2021
Docetaxel×6
Luis Barreras
Apr 23, 2021
Use docetaxel
Abdelhamid Sabaa
Apr 23, 2021
Both Enzalutamide and Arbiraterone + Prednisolone are suitable alternatives. I would suggest keeping the Docetaxel for relapses
Sava Micic
Apr 23, 2021
Docetaxel 6 cycles
Oscar Londono
Apr 23, 2021
Docetaxel
Charles Maack
Apr 23, 2021
Enzalutamide (Xtandi), but if not effective, olaparib (Lynparza) or rucaparib (Rubraca), and if still not effective, docetaxel plus carboplatin x6 cycles. If all not effective but patient still mobile, possibly pembrolizumab (Keytruda).
John Ochai
Apr 23, 2021
Docetaxel 6 cycles
The patient is young and with good performance status so should be offered upfront Docetaxel chemotherapy
Saad Benjelloun
Apr 23, 2021
Enzalutamide
emine sevil bavbek
Apr 23, 2021
Docetaxel 6 cycles. Tempted to add platinum with the BRCA mutation, but no data in the HAPC setting
Luis Felipe Lara Moscoloni
Apr 23, 2021
1 enzalutamide
2 olaparib
3 docetaxel
Charles Maack
Apr 23, 2021
Two research comments:
Germline BRCA2 carriers who received first-line abiraterone or enzalutamide (Xtandi, Astellas) vs. taxanes had longer cause-specific survival (24 months vs. 17 months) and PFS2 (18.9 months vs. 8.6 months).
Patients with metastatic castration-resistant prostate cancer and harboring germline mutations in BRCA1/2 and ATM benefit from treatment with abiraterone and enzalutamide
Charles Maack
Apr 23, 2021
In any event, a prognosis for a patient with the status identified is, unfortunately, not good despite the good intentions of suggested therapies.
Syamsu Hudaya
Apr 24, 2021
Docetaxel 6x
farhood khaleghi mehr
Apr 24, 2021
docetaxel×6
Antonio Rosino-Sánchez
Apr 24, 2021
apalutamide or enzalutamide. Chemo after progression (docetaxel plus platin based). Olaparib if progression after chemo
Manuel Ossa
Apr 28, 2021
doxetacel x 6 cycles
Khoury Elie
Apr 29, 2021
Olaparib
Rosanna Mirabelli
Apr 29, 2021
docetaxel (alto rischio alto volume)
Oliver Sartor
May 07, 2021
More clinical trial clearly needed in this space....one day we may add a PARP inhibitor. The ADT + "novel hormones" gives a better PFS than ADT + docetaxel.....buying more time until progression allows to be more creative in the future. This patient may respond well to DNA damaging agents like Lu-177 tagged to PSA targeting agents. Would be great to get the trial open with ADT + novel hormone +/- PSMA Lu-177
Charles Maack
May 07, 2021
Dr. Sartor’s recommendation for Lutetium-177 PSMA is certainly one of the best approaches in this case once approved by the FDA. Currently, this treatment is only approved for use in Germany, with a few other countries prescribing as a novel treatment option. So far with Phase III of the VISION trial, the intermediate results demonstrate that Lutetium-177 PSMA therapy leads to a significant improvement in biochemical and radiological parameters, improves the quality and general life expectancy of patients with metastatic prostate cancer. According to statistics obtained during the relevant international VISION and LuPSMA trials, the use of Lutetium-177 leads to a significant improvement in the results of laboratory tests and PET-CT (more than 57% of patients), and also improves quality (more than 70% of patients) and expectancy of life (more than 45% of patients).
selcuk seber
Sep 27, 2021
cabazitaxel carboplatin combination since this patient is very high risk and organ metastatic disease is a surrogate marker for relative anti hormonal therapy resistance . Although the pathology did not report the existence of neuroendocrine features further molecular diagnostics will probably reveal Rb and p53 Co existence. In any case at least carboplatin should have a place in the first line treatment of this patient.
Prasanta Kumar Pradhan
Apr 03, 2022
Lu-177 PSMA therapy seems to be a better therapeutic choice in this scenario.
Apr 18, 2024
Pending Moderator approval.
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Pedro
C.
Barata
MD
Waleed Ragab
Apr 23, 2021
Kenneth Chen
Apr 23, 2021
Jose Luis Soto Rodriguez
Apr 23, 2021
Hadi Molana
Apr 23, 2021
Muho Ahmed
Apr 23, 2021
Rene Henriquez
Apr 23, 2021
Thomas Zahreddin
Apr 23, 2021
Kazuyuki Sagiyama
Apr 23, 2021
Bahram Mofid
Apr 23, 2021
Luis Barreras
Apr 23, 2021
Abdelhamid Sabaa
Apr 23, 2021
Sava Micic
Apr 23, 2021
Oscar Londono
Apr 23, 2021
Charles Maack
Apr 23, 2021
John Ochai
Apr 23, 2021
Saad Benjelloun
Apr 23, 2021
emine sevil bavbek
Apr 23, 2021
Luis Felipe Lara Moscoloni
Apr 23, 2021
Charles Maack
Apr 23, 2021
Charles Maack
Apr 23, 2021
Syamsu Hudaya
Apr 24, 2021
farhood khaleghi mehr
Apr 24, 2021
Antonio Rosino-Sánchez
Apr 24, 2021
Manuel Ossa
Apr 28, 2021
Khoury Elie
Apr 29, 2021
Rosanna Mirabelli
Apr 29, 2021
Oliver Sartor
May 07, 2021
Charles Maack
May 07, 2021
selcuk seber
Sep 27, 2021
Prasanta Kumar Pradhan
Apr 03, 2022
Apr 18, 2024
Pending Moderator approval.