New endocrine therapy with abiterone for metastatic hormone sensitive prostate cancer: a case report and literature review / 中华泌尿外科杂志

ABSTRACT

To investigate the clinical characteristics of metastatic hormone sensitive prostate cancer and explore the strategy of combination of new endocrine drugs.In April 2019, an 69-year-old man was admitted to the First People’s hospital of Changzhou with "gross hematuria" . Physical examination showed prostatic hyperplasia with an unsmooth hard surface. CT showed a mass in bladder and possible metastasis in right lung. Diagnostic TUR-Bt pathology showed prostatic acinar adenocarcinoma, and PET-CT showed malignant lesion of prostate with bladder invasion, multiple pelvic lymph node metastasis and lung metastasis. The diagnosis of mHSPC with lymphatic and lung metastasis was considered. The patient was treated with bicalutamide and then switched to goserelin plus acetate abiraterone with prednisone. Total prostate specific antigen (tPSA) decreased to 0.705 ng/ml after 1 month of ADT+ AAP treatment, and decreased to 0.007 ng/ml after 4 months, and then maintained at 0.003 ng/ml until January 2021. Serum testosterone decreased to 0ng/dl and maintained the whole follow-up period. After 3 months of treatment, the pulmonary metastasis was not obvious. Till the last follow-up at January 2021, the patient reported good quality of life with no serious adverse events. The efficacy of ADT combined with acetate abiraterone in the treatment of mHSPC with lung cancer was significant.