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OpenOnco · Diagnostic · mPC restage · Rising PSA + bone mets post-RP (Gleason 9)
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OpenOnco · Workup Brief · DIAGNOSTIC PHASE
Pre-tumor-board workup brief
DPLAN-PZ-DIAG-METPRO-001-V1 · v1 · 2026-05-12
Patient
PZ-DIAG-METPRO-001 · suspicion lineage: prostate_cancer_metastatic
Tissues: prostate, bone, lymph_nodes_pelvic · Hypotheses: DIS-PROSTATE
73M with prostate_cancer_metastatic suspect — biopsy-confirmed prostate adeno (Gleason 4+5=9, pT3a, ISUP 5) on radical prostatectomy 4 yrs ago, post-op PSA nadir 0.05. Rising_psa over past 12 months: 0.05 → 0.8 → 4.2 → 12.4 ng/mL (PSA doubling time 4 months — rapid). New onset of right hip and lumbar back pain × 6 weeks. NM bone scan: increased uptake L3 vertebral body + right iliac wing → bone_metastases suspect. Pelvic MRI: prostate fossa unremarkable, but 2 new pelvic lymph nodes 1.4 + 1.1 cm. Testosterone 480 ng/dL (castrate-sensitive — mhspc vs early progression). Pre-existing hypertension + T2DM + CrCl 62. No prior systemic therapy (post-op surveillance only). Needs PSMA-PET for accurate staging + germline + somatic HRR before Tx (ARPI doublet vs triplet, PARPi if BRCA+).

Workup steps (4)

MDT brief

MDT talk tree (2 steps)

#OwnerTopicAction
1pathologistSpecialist review Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
2radiologistSpecialist review Stage / restaging imaging + biopsy guidance — radiologist.

Skills (required) — mandatory virtual specialists (2)

  • Pathologist (general) required
    Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
  • Radiologist required
    Stage / restaging imaging + biopsy guidance — radiologist.
Technical MDT skill metadata (2/16 activated in this plan)
All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).
Specialistskill_idVersionLast reviewedSign-offsDomain
Cellular therapy specialist (CAR-T)cellular_therapy_specialistv0.1.02026-04-250cellular_therapy
Clinical pharmacistclinical_pharmacistv0.1.02026-04-250clinical_pharmacy
Hematologist / oncohematologisthematologistv0.1.02026-04-250hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)hematopathologistv0.1.02026-04-250hematopathology
Infectious disease / hepatologyinfectious_disease_hepatologyv0.1.02026-04-250infectious_diseases
Medical oncologist (solid-tumor chemotherapist)medical_oncologistv0.1.02026-04-250solid_oncology
Molecular geneticist / molecular oncologistmolecular_geneticistv0.1.02026-04-250molecular_oncology
Palliative carepalliative_carev0.1.02026-04-250palliative_care
Pathologist (general)pathologistv0.1.02026-04-250pathology
Primary care / family physicianprimary_carev0.1.02026-04-250primary_care
Psycho-oncologistpsychologistv0.1.02026-04-250psychosocial
Radiation oncologistradiation_oncologistv0.1.02026-04-250radiation_oncology
Radiologistradiologistv0.1.02026-04-250diagnostic_imaging
Social worker / case managersocial_worker_case_managerv0.1.02026-04-250psychosocial
Surgical oncologistsurgical_oncologistv0.1.02026-04-250surgical_oncology
Transplant specialist (BMT)transplant_specialistv0.1.02026-04-250cellular_therapy
plan_id: DPLAN-PZ-DIAG-METPRO-001-V1 | version: 1 | generated: 2026-05-12T18:41:26.955375+00:00
Per FDA non-device CDS positioning (CHARTER §15): Diagnostic-phase MDT support: structure the workup, identify the team, surface unresolved questions. Not a medical device; not a treatment plan.
Per FDA non-device CDS positioning (CHARTER §15): DIAGNOSTIC PHASE — this output describes diagnostic workup only. Treatment plan generation is blocked until histology is confirmed (CHARTER §15.2 C7). Do not treat on suspicion.
This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.