Broad Survey of the State of Prostate Cancer Diagnosis and Treatment in a recent Article in the New England Journal of Medicine by Dr. Sartor (Snuffy Myers pal)
"We review studies that are changing the standard of care, and we offer a conceptual perspective for addressing ongoing challenges and opportunities."
"...new protocols will come from Immunology, targeted therapies for PARP Inhibitors, selected for each particular Mutation to allow for DNA repair."
Nalakrats, what of these to your knowledge, are currently available to people with metastatic prostate cancer, or can reasonably be expected to be approved for payment by insurance companies and/or Medicare in the next year?
Thank you. I think think I looked up so many articles form the nejm that they think I am a heavy user. Thus they cut me off from getting articles free.
The article sounds very interesting, although I was unable to open it and read the full article.
Nalakrats, thank you for sharing your own data and experience with gene mapping and your positive thoughts on what the future may hold for people with prostate cancer.
I do think that for Paul, unfortunately, it is a little too late. I am not sure that he will live long enough to benefit from any of those new treatments or ideas.
When I asked our oncologist the other day what he thought about gene mapping and immuno therapy treatments he turned to me and said, "I think we have gone beyond that to be honest." And, to be honest, I think he may be right. We don't have time to mess around with treatments and have to use what is there and proven to work.
However, if we were to get Paul's gens tested, how and where would that happen? What is the process like?
Mel , if genetic testing could be done with a blood test as they do at quadrant, it may be able to identify a mutation with a therapy that is proven to work, I have read where myers said he had a patient with weeks to live, they found the mutation,There is a 33% chance of a mutation being found .got the treatment and they guy went off hospice and was thinking of going back to work, so Try to get it done. For me to get a surgical biopsy og abdominal mets ,was way to much, ended up with a week in hospital and a much weakened state, I could handle a blood test though. I also agree with Nalakrats about lighting a fire under the MOs ass. It also sounds like a good idea to be tested for psam to see if LU177 would work. I sometimes feel like my expert has put me out on an ice flow, however my local is very good and willing to try anything, so I am going with her for now.
All patients were enrolled between 10/2015 and 12/2016 (median age 69 yr, ECOG 1; PSA doubling time 2.2 months) with 3 pts awaiting a final treatment cycle. 87% received prior chemotherapy, 47% cabazitaxel and 83% prior abiraterone and/or enzalutamide. Mean dose was 7.5 GBq (range 4.4 – 8.7 GBq) prospectively adjusted according tumour burden, renal function and weight. At this interim analysis, 17/30 pt (57%) achieved PSA decline >50%, including 11/30 (37%) with decline >80%. In 17 pt with soft tissue disease, objective response (RECIST PR+CR) occurred in 12 pt (71%).
Lots of these are initially NOT developed for prostate cancer. But if you Google drug names with 'prostate cancer' for example ("pembrolizumab and prostate cancer"), you will see trials ,like Keynote, that are starting to apply therapies and combo therapies to prostate cancer patients.
As I mentioned before besides my Pca I also have stage IV melanoma of the left lung. Following is my treatment log using Keytruda at $30K per treatment every three weeks).Number 1 treatment with KEYTRUDA on Tuesday 02/07/2017
Number 2 treatment with KEYTRUDA on Tuesday 02/28/2017.
*Took CT body scan on Thursday, 04/06/2017
Number 3 treatment with KEYTRUDA on Tuesday 04/21/2017. (SKIPPED!)
Dr. said that my recent C.T. scan (04/06/2017) showed that the nodule on my left lung decreased in size.
Lungs: Decreased lower lobe metastasis:
Now 1.2 x 1.0 cm. previously 2.4 x 2.2 cm.
Pleura/pericardium: Resolved small left pleural effusion.
Number 3 treatment with KEYTRUDA on Tuesday 04/11/2017.
Number 4 treatment with KEYTRUDA on Tuesday 05/02/2017.
Number 5 treatment with KEYTRUDA on Tuesday 05/23/2017.
Number 6 treatment with KEYTRUDA on Tuesday 06/13/2017.
Number 7 treatment with KEYTRUDA on Thursday 07/06/2017.
*Took CT body scan on Tuesday, 07/18/2017.
Dr. said that my recent C.T. scan (07/18/2017) showed that the nodule on my left lung decreased in size.
Lungs: Decreased left lower lobe metastasis:
Measuring now 0.6 x 0.6 cm. previously 1.2 x 1.0 cm.
No new suspicious lung nodules.
Pleura/pericardium: No effusion.
Number 8 treatment with KEYTRUDA on Tuesday 07/25/2017.
Number 9 treatment with KEYTRUDA on Tuesday 08/15/2017.
Number 10 treatment with KEYTRUDA on Tuesday 09/05/2017.
Number 11 treatment with KEYTRUDA on Tuesday 09/26/2017.
Number 12 treatment with KEYTRUDA on Tuesday 10/17/2017.
*Took CT body scan on Monday, 10/30/2017.
Number 13 treatment with KEYTRUDA on Tuesday 11/07/2017.
Dr. said that my recent C.T. scan (10/30/2017) showed that the nodule on my left lung stayed the same size and that was a good sign.
Number 14 treatment with KEYTRUDA on Wednesday 11/29/2017.
Number 15 treatment with KEYTRUDA on Wednesday 12/20/2017.
Number 16 treatment with KEYTRUDA on Wednesday 01/10/2018.
*Took CT body scan on Friday, 01/26/2018.
I met with Dr on Wednesday, 01/31/2018 and based upon my CT Scan of 01/26/2018 he said that I do not need any more treatments for 3 months since my scan showed the following
LUNGS/AIRWAYS: Further decreased residual ill-defined left lower lobe metastasis, barely perceptible. No new suspicious nodules. Schedule for a CT Scan on 04/24/2018 and a consultation with Dr. on Tuesday, 05/01/2018.
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