PMC8669273_01
The surveillance of PSA level since initial diagnosis. The red arrow represents the prostatectomy, and the red star represents death. The online part and the line length represent the therapeutic regimen and therapy time, respectively. The PSA level at death was unknown.
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PSA level to evaluate the therapeutic effect (Figure 1). Prostatectomy was performed followed by 4-month flutamide (250 mg three times a day), continued goserelin (3.6 mg every 4 weeks until passing away), and 6-week chemotherapy with docetaxel (75 mg/m2 every 3 weeks) combined with zoledronic acid therapy (4 mg every 4 weeks until month 36). AR mutation was only detected in the tissue sample (Figure 2 and Supplementary Table 1).
NGS analysis of the lung metastasis and plasma samples. (A) Missense mutation of AKT1 p.E17K in lung tissue and plasma samples. (B) The deletion mutation (c*612-2173+34del) of exons 5-7 and a part of exon 8 of AR in lung tissue.
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AR mutation was only detected in the tissue sample (Figure 2 and Supplementary Table 1).
The lung and pleural metastasis were reduced after everolimus treatment. (A) CT image of lung metastasis before medication of everolimus. Arrows represent pulmonary metastases. (B) CT image of pleural metastasis before medication of everolimus. The arrow in the lower left corner represents the pleural effusion, and other arrows represent pulmonary metastases. (C) CT image of lung metastasis after everolimus treatment for 3 months. (D) CT image of pleural metastasis after everolimus treatment for 3 months.
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CT imaging also revealed that the size of the lung lesion was remarkably reduced, and the size of the bone metastasis remained stable (Figure 3).