2 yr ago: PSA 456 ng/ml, bone & CT scan: 8 bone mets (4 on vertebral bodies, 2 on pelvis and 2 on ribs).

ADT+DOC+DARO started. After 6 cycles, PSA ↓ to 5 ng/ml.

Current situation, 1.5 years after stopping DOC, tx with DARO still ongoing:

• No comorbidities, asymptomatic, ECOG PS: 0, no relevant family history
• Rising PSA: 40 ng/ml, T: 17 ng/dl (0.59 nmol/l)
• Bone & CT scan: pelvic and retroperitoneal LNs (all <3 cm), progression of existing bone mets and 1 new mets on femur (9 mets in total)
• PSMA-PET/CT: concordant with CT and bone scan, all lesions PSMA positive and higher PSMA expression than liver
• No germline or somatic mutations detected