ADT + ARPI mHSPC, mCRPC progressive on DOC.

Has no relevant family history.

Current situation, after 5 cycles of DOC:

ECOG PS: 1, mild pelvic pain (VAS score 3)
PSA: 50 ng/ml
Bone & CT scan: progression in bone (12 lesions in total), pelvic and retroperitoneal LNs (3 lesions in total, max 3.5 cm in short axis)
PSMA-PET/CT: concordant with CT and bone scan, all lesions PSMA positive and higher PSMA expression than liver
No germline and/or somatic HRR/BRCA mutation identified

Score of experts

Uromigos score (range: 0-3)

As not all drugs have the same clinical impact despite getting similar guideline levels of recommendation, the Uromigos Score is designed to quantify clinical support for various approaches. We asked each expert to score a given treatment according to the following:

3 Undisputed SOC

2 Potentially inferior to SOC but a reasonable option

1 Has a limited role

0 Should be avoided

Only 1 option can be selected with Score 3. We assumed patients are fit/eligible/appropriate for all treatment options without contraindications, preferences, or limitations of availability/funding. The mean of all scores is presented.

Reference: Uromigos Score — The Uromigos

Mean Uromigos score

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*docetaxel continuation/rechallenge