Case 2025: James (expert opinion by R. Jones)

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PIs and adverse event statement can be found at the bottom of the page.

James, 71 years old, is a former baker. Together with his son, he ran a small bakery that might easily go unnoticed if it weren't for the irresistible aroma of freshly baked pastéis de nata drifting through the air. The scent of these iconic Portuguese treats draws both locals and tourists, who happily form long lines just to get a taste.

Unfortunately, James is now diagnosed with metastatic hormone sensitive prostate cancer (mHSPC).

• Medical history: myocardial infarction 4 years ago, currently stable on antiplatelet therapy, a statin, and an ACE-inhibitor
• ECOG PS: 1
• Symptoms: back pain and weight loss over the last few months
• PSA: 38 ng/ml
• Prostate biopsy: ISUP grade group 4 (Gleason 4+4)
• Bone scan: 7 metastases (3 on spine, 3 on pelvis and 1 in the left rib)
• CT: locally advanced prostatic mass, few enlarged pelvic lymph nodes, no visceral metastases
• No actionable germline or somatic mutations detected

Combination systemic therapy is planned.

EUR-Onc-Org-01641 - November 2025