Advanced Prostate Cancer

AR-V7, Zytiga(abiraterone) and Xtandi (enzalutamide)

According so some studies, 40-50 percent of patients receiving any of the above drugs do not respond well or develop resistance in about one year. I am curious to know if any of you who are already taken these drugs know whether you have been genetically screened for the presence or absence of AR-V7 prior to taking the drug and the resultant PSA response. See ascopubs.org/doi/full/10.12... these drugs depended on the absence of AR-V7 to be effective.

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My Geneticist---and few or no-one has one in their treatment plan here---told me the same thing 2 years ago what you are saying---yes it is true--AR-V7 can cause Zytiga and Xtandi to fail---usually you get about 6 months out of the drugs, before failure begins. Taking the test for a 1,000 dollars--my Geneticist said was a waste of money---because you will get usually 6 months of value, you will then know you have the AR-V7 turned on, without having to pay for the test.

And there are a few agents that Turn it off---among them Chemo, High T injections, as like BAT, High Doses of DIM, BIRM, nano Olaparib for those with BRCA Mutations--and a few others that are suspiciously positive as to the AR-V7. Certain Chelating agents that go after Copper, have also been reported to work.

When one of these protocols work, you have resensitized the body to use Zytiga and Xtandi again.

Nalakrats

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Nal,

I seem to remember that you posted where you purchase your BIM. Would you mind letting my know your preferred source? Thanks Charlie

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Single strength BIRM, I get from Amazon, 7X strength. can be obtained by calling a number in the USA, where this distributor gets it from Ecuador--the Tel number is 408-612-4508.

If you do not know: BIRM is under investigation by the University of Miami's Medical School--and funded by the Gov'ts NIH, to the tune of millions of dollars. I do not know if they are doing trials, or work-up studies on this USA patented Material.

For a lot more information, you could call the medical school, and talk to those heading the work. I have not done so at this time.

What I do know is that the single strength is more of a maintenance material that helps in maintaining one's self against a cancer that is somewhat under treatment control--and that the 7X is a strong almost likened to a Natural Chemo agent, that might be, I said might be, effective against stopping cancers that are starting to gallop.

I am not a Doctor---and I do use the single strength--it is a part of my Supplemental program. Since it is used with many other supplements, it is impossible for me to determine, how much benefit I get from it.

True after 2 years--of ADT, and my program, I am now on vacation--yet I consider BIRM to still be a part of my daily program.

There must be something to it. I say,--as the Gov't does not easily just nilly willy fund Prostate Cancer Research--at Medical Schools. Now it did with Xtandi---and UCLA Medical, and that was a success.

I give you my thoughts here so you can make up your own mind as to use. I cannot sanction.

Nalakrats

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Thanks Nal! The cancer inside me seems to galloping at the moment. Went thru zytiga and xtandi and 6 cycles of docetaxel. While on Doce my lymph nodes in my chest were determined to now be involved with enlarged nodes pushing against my lung. Am currently on cycle 2 with cabazitaxel with much fewer side effects. My goal is to be able to participate in my daughter's wedding at end of September!

I've always been impressed with your posts and the knowledge they embody. I'm so glad your program has worked so well for you. I also hear your reluctance to offer advice. Am wondering however if you would mind reviewing my supplement list and hypothesizing on any changes. If this is something you'd be interested in then I would send you my stats and supplement list. I know this is a big ask considering what you've written before.

Charlie

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Use Messenger---and let me take a look.

Nalakrats

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Data:

Very good questions. It is my understanding that patients are nor routinely screen for androgen receptor variants. Recently they have not found association with the presence of AR-V and resistant to abiraterone and enzalutamide.

Expression of Androgen Receptor Splice Variant 7 or 9 in Whole Blood Does Not Predict Response to Androgen-Axis-targeting Agents in Metastatic Castration-resistant Prostate Cancer.

To SQ1, Kwan EM2, Fettke HC1, Mant A3, Docanto MM1, Martelotto L1, Bukczynska P1, Ng N4, Graham LK5, Parente P6, Pezaro C6, Mahon K7, Horvath L8, Todenhöfer T9, Azad AA10.

Author information

Abstract

In 2014, a landmark study was published demonstrating that the expression of androgen receptor splice variant (AR-V) 7 was a negative predictive biomarker for response to abiraterone acetate and enzalutamide in metastatic castration-resistant prostate cancer (mCRPC) patients. However, these results were not supported by the recently reported ARMOR3-SV phase III clinical trial, which employed an identical circulating tumour cell assay to assess AR-V7 expression. Therefore, the predictive utility of AR-V7 expression in mCRPC remains uncertain, as does any potential association between other AR-Vs and treatment response. To further investigate, we designed a highly sensitive and specific whole blood assay for detecting AR-V7 and AR-V9. We then examined for a correlation between baseline AR-V7/V9 status and treatment outcome in 37 mCRPC patients commencing abiraterone or enzalutamide. Of the patients, 24% (9/37) were AR-V-positive. Notably, prostate-specific antigen (PSA) response rates did not significantly differ between AR-V-positive (6/9) and AR-V-negative (18/28) patients (66% vs 64%, p=0.9). Likewise, median PSA progression-free survival was not significantly different between AR-V-positive and AR-V-negative patients (9.2 mo vs not reached; p=0.9). These data, which support the findings of the pivotal ARMOR3-SV clinical trial, suggest that baseline AR-V expression does not predict outcomes in mCRPC patients receiving abiraterone or enzalutamide.

PATIENT SUMMARY:

Detection of androgen receptor splice variants (AR-Vs) in circulating tumour cells of advanced prostate cancer patients has been linked to resistance to abiraterone and enzalutamide. We designed a blood test to detect AR-Vs that can be performed more routinely than tests involving circulating tumour cells and found that patients with AR-Vs still benefit from these effective treatments.

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I was told that you go through the list of ADT drugs, each one will have a shorter time of efficacy. Which seem to be true in my case. Casodex was effective for 5 years, Aboratorone, lasted 3 and 1/2 years, I am currently on xtandi and it has been effective now for 2 years, don't know how much more I can get out of it.

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AR-V7, hmmm? Makes me wonder if I should get typed before I go the trouble of entering EMBARK clinical trial next week. My PSADT is currently 2 months over last 12 months and BCR after being 0.02 for 4 years after SRT in 2013. Also wondering about Estradiol supplementation or as a substitute for Leuprolide.

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Rust, as in many clinical studies, it seemed that there are other researchers that dispute the impact of AR-V7 (see link shown by other member of this group in subsequent posts). All we know is that not everyone on Zytiga/Xtandi respond favorably to these drugs. Similarly, the subject of estradiol is controversial. I read articles that in men, estradiol is an agonist (promoter) to prostate cancer growth, in the absence of testosterone. The EMBARK study is pretty benign, and if you haven’t been on ZYTIGA or XTANDI, should be considered, as they provide access to you on these relatively new drugs, which cost a ton if you were precribed normally .... Good luck and read this about estrogen (in other word, estradiol): ncbi.nlm.nih.gov/pmc/articl...

Julius

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One other thing, it is MY belief that T-suppression, AR and similar drugs are just stop gaps in controlling prostate cancer growth but not really eliminating it for good. My hope is that genetic based treatment that awakens our immune system to fight our cancer is the one that will finally provide us a cure. PTEN and PARP studies (like this: ncbi.nlm.nih.gov/pubmed/292... I think is the key to our future survival from prostate cancer.

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