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ESMO Preceptorship Programme
Liver metastasis in prostate cancer: a predictor of
poor survival
Sara Coelho, Instituto Português de Oncologia do Porto Francisco Gentil, EPE
Prostate Cancer – Lugano, Switzerland – October 4, 2018
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ESMO PRECEPTORSHIP PROGRAMME
DISCLOSURE
� No conflicts of interest to declare.
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ESMO PRECEPTORSHIP PROGRAMME
Clinical Case
� A 62 year-old man was admitted to our center with suspected liver
metastases. The study revealed a stage IV (cT2N1M1) prostate
adenocarcinoma (hepatic and bone metastasis), Gleason 8 (4+4), PSA
36.8ng/mL, diagnosed in 27.07.2015.
� ECOG PS 0; IMC 29Kg/m2; past medical history of arterial
hypertension, dyslipidemia, psoriasis, depression and osteoarticular
degenerative disease with bilateral total hip prosthetic replacement
07.2015
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ESMO PRECEPTORSHIP PROGRAMME
Clinical Case – Timeline
� Stage IV Prostate Cancer diagnosis
� Initiated LHRH agonist (goserelin)
� Docetaxel 75mg/m2 6 cycles (every
21 days), PSA nadir 1.59ng/mL in
5/2016, with partial response (best
response)
07.2015
09.2015
01.2016
11.2016
10.2015
mCRPC
05.2015 02.2016
02.2016
11.2016
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ESMO PRECEPTORSHIP PROGRAMME
Clinical Case – Timeline
� Docetaxel 75mg/m2 9 cycles (every 21 days), PSA nadir 4.18ng/mL in 7/2017, Stabilized
disease (best response)
� Initiated Zoledronic acid 4mg (every 28 days)
� Cabazitaxel 20mg/m2 cycles 5 cycles (every 21 days), without clinical or biochemical
response and imagiological disease progression (volumetric increase of known hepatic
lesions); ECOG PS 2
� Proposed for abiraterone acetate or enzalutamide
12.2016
05.2017
01.2018
03.2018
06.2018
07.2018
12.2016
PD
PD
01.2017 01.2018
05.2018
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ESMO PRECEPTORSHIP PROGRAMME
� Liver and lung metastases are relatively uncommon in patients with
mCRPC (approximately 9% liver metastases)
� Of the non-LN metastatic disease, liver metastases seem to be an
important adverse predictor of OS in men with mCRPC treated with
docetaxel
� Taxane-based chemotherapy seems to be beneficial in this patient case
with clinical, biochemical and imagiological response.
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ESMO Preceptorship Programme
Thank you for your attention!