AR-V7 - CTC's - Risk of Death

I know guys whose Docs put them on Xtandi as soon as they had a BCR on Lupron

But, before Xtandi insist on the new test below...AR-V7 protein in CTC's was predictive of 76% reduction in risk of death when taxane chemo was used in place of Xtandi or Zytiga

Gus

urotoday.com/recent-abstrac...

12 Replies

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  • The claim is that finding AR-V7 in the nucleus indicates that Xtandi/Zytega wont work.

    [I didn't understand what it says, if anything, about if AR-V7 is found in the cytoplasm, or on the cell membrane.]

    It says if ARV7 is in the nucleus and you get taxane, you are 76% less likely to die, meaning less likely to die than if you get X/Y. But since they say that X/Y does not work if there is ARV7 in the nucleus, that means you might as well not give it, and that means that if you get taxane, you are 76% less likely to die than if you do nothing. Right?

    So if you had a 50% chance of dying in a year, and you take taxane, then you have a 12% chance of dying in a year? And that, the "76%", seems to say more about the effectiveness of taxane than anything else. Why say it in an article about AR-V7?

  • I think the best route would be to combine Xtandi with chemo. Martin, can you describe your treatment with Provenge..do you have CRPC...I would like to get Provenge but I do not have CRPC..can I still receive treatment

  • Provenge has been pretty routine. Blood out on Friday. Back in on Monday. Pretty much a non-event, except it seems to dominate the whole day, is creepy, and you get trembly inside. Yes my PSA is rising on ADT. If you have mets, you eligible, whether or not CRPC.

  • Provenge is only approved for men with CRPC.

    There was a trial called the STAND trial (NCT01431391) begun in 2011. It was designed to determine if adding Provenge to ADT in men with biochemically recurrent prostate cancer after initial treatment with surgery and/or radiotherapy had any potential difference to the outcomes.

    Basically, the data was inconclusive. This result will not encourage any insurance company to pay for Provenge in any man with hormone responsive disease.

    Joel

  • Joel,

    what is your opinion of Prostvac

    Gus

  • Still in clinical trials so we don't yet have any survival data. I believe and hope that it will provide a survival advantage, but until they have enough events and un-blind the study we will not know. If you are interested in participating in the trial I think that it makes sense, risks seem relatively low with some possible up side.

    Joel

  • Hey Guys, My Geneticist, which I mentioned before--has explained to me that the AR-V7, can turn on and off.That Chemo of any type can cause the AR-V7 to turn off, and it has been shown to turn on, and when on the X/y will not work.

    But a new paper just published---if you have to read it I can find it--I read it---Was preforming BAT, using the John Hopkins protocol with T at 1500, when on T, and doing 3 infusions of T, and then cycling off---The Men in the study were all tested for having the AR-V7, turned on.

    All men that had the Positive AR-V7 Gene splice no longer had it after 3 rounds of BAT. The study concluded more testing would be required due to sample size. But the fact is all men put on BAT, blew up their AR-V7--or it became undetectable.

    So in my pea brain, I have concluded that, BAT Hormone intervention appears to have another affect, besides lowering PSA, by more than 50% , in more that 50% of the men doing it, it also negates the AR-V7, which then allows X/Y to be very effective.

    Nalakrats

  • Nal,

    you are right about BAT and AR-V7 according to a study I read. But, it seems BAT is worth trying when Xtandi fails...BAT can be dangerous as some cancers got worse. Patrick is doing a form of BAT..on 3 months and ADT 3 months...but Patrick has bone mets which he might not have if he had just done lupron.

    Gus

  • The terminology "turn on" and "turn off" seems misleading. I think that better is that cells with v7 are still vulnerable to taxane.

  • See my other reply

    Nalakrats

  • I do not think it appropriate to discuss what Patrick is doing or not doing, unless he describes what he is doing, in a public manner. But I believe you are somewhere in the same church, that he is involved in, some protocol, off the main road.

    Nalakrats

  • Ok, my husband was very successful on zytiga, 4 years in fact. Now it is failing and they want him to go on xtandi. Should he still get the test?

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