BRCA And Parp inhibitors

[MartinSpurs]

Hi. I was diagnosed at age 57 with stage 4 Metastatic PC in Nov 2015 with widespread bone mers and mets to lymph nodes Unusually the original tumor was never found and hence I do not have Gleason score and had no Prostate surgery.

I have been through Bicalutamide (Casodex), Chemo (Docataxel), Zytiga and Xtandi treatments. All have worked for a while and then failed.

Recently I was confirmed with BRCA2 gene mutation, both germaine and in a sample tumor.

I was able to gain access to a PARP inhibitor Rucaoarib,but unfortunately this also seems to have had a brief positive response and is now failing after 3 months.

My choices seem to be try another PARP inhibitor or move to a Platinum based chemo drug Carboplatin. I really don't want Chemo again if I can help it as I had a pretty rough time on Docataxel.

Does anyone know if another PARP inhibitor can give different results or are they all fairly similar? There have been some fantastic results reported with Olapatib and MCRPC. I was really hoping I might get similar from the Rucaparib, but you know, the roller coaster of ups and downs continues.😀

I think my MO, who is fantastic, is leaning towards Carboplatin, but would love to hear from anyone who is receiving treatments while is BRCA positive.

Other drugs I am on currently apart from pain killers are Zoladex 3 monthly, Vit D monthly, Zometa infusion monthly.I have had extensive radiation therapy over the past 2 years for pain relief with good results.

Thanks for reading this far and best wishes to everyone on the site.

Martin

[Tonyland]

Great question. I'm interested in knowing this as well. My dad is currently on chemo with hopes to enter a Park trial. He is also Brca2 but based on tumor.

[Tall_Allen]

One patient reported some very tough side effects from a PARP inhibitor - I don't know if carboplatin would be any worse for you. The only way to know is to try it. It may be difficult getting on a clinical trial for one PARP inhibitor after you've tried another one.

[MartinSpurs in reply to Tall_Allen]

Hi Allen

Rucaparib has made me very tired, but that is the only real side effect for me. As per response above I will probably be going the Carboplatin route ( a platinum based chemo drug) and then if necessary re-evaluate from there.

Martin

[MartinSpurs]

Hi Nalakrats

My mutations from the Foundation One report are:

BRCA2 D252fs*24

ABL1 K609del

TBX3 E195fs*13

TET2 splice site 4183-1G>C

As far as I can tell only the BRCA one is considered significant at this point in time.

I think Olaparib is the way to go, access is the issue I'm afraid. I'm guessing I will be going the platinum chemo route, lets see what those PSA results say in a couple of weeks. Maybe I will get a pleasant surprise!

Martin

[billyboy3]

Men:

I am astounded at the knowledge our group has, coupled with the incredible amount of research that is being done, sadly, to little effect thus far.

What I would like to have done is for us to get everything documented in simple form so that one can chart out one's own case and options as the disease progresses. We tried this many years ago, but due to hardcopy, was hard to keep it up.

A second purpose of said documentation and summary of treatment options is to allow us to get onto various drug trials easier and also to promote and support the good guys and those making progress in the treatment of PC.

Please let me know your thoughts, Daryl if you are reading this, please let me know.

Lastly, the sad fact is most of us will die of PC or related illness caused by it or treatment therein. I recommend that you live large, make a bucket list and enjoy each moment. In my case, once my IHT effectiveness ends, so will my time come to a close. One has to sort out the end of treatment options and time on the planet. There is a limit to the pain and suffering that this damn disease inflicts upon us in the late stages, and I think we need to recognize this and respect those who do not or cannot carry on the fight, dying with dignity and in one piece is worth discussing and accepting.

[vandy69]

Good Thursday Morning Martin,

My cancer had an ATM defect (found by Guardant360 liquid biopsy) which permitted Dr. Snuffy Myers to prescribe Lynparza, another PARP inhibitor. It worked for me for about 9 months with few side effects. Very expensive if not covered; Medicare and Supplemental plan covered all of mine with deductibles of course.

In September 2017, I began 6 cycles of Docetaxel/Carboplatin chemo, due to PSA rising and mets in liver. PSA dropped from 10.8 to .4 and liver lesions got smaller. Normal side effects from chemo, so cannot comment on any specific side effects from Carboplatin.

Best wishes. Never Give In.

Mark, Atlanta

[MartinSpurs]

Hi Mark, greetings from Auckland, New Zealand.

I'm glad you are responding to the chemo.

Strangely, carboplatin is publicly funded down here and Lynparza (Olaparib) is not. Hence I suspect my Onco will recommend Chemo next.

Lynparza would cost around $10k per month.

Best wishes and enjoy what we have while we have it.

Martin

[Hidden in reply to MartinSpurs]

Hey Mark,bummer you are on here mate.... Im down in Marton. 57 as well

[MartinSpurs]

Hi Dave

We are certainly a lot closer than we are to most in this group!

I'm in Auckland, if you are ever up this way and fancy a coffee or a beer, give me a shout. Likewise if you ever feel like a chat feel free to text or call 021 734242.

Kia kaha

Martin

[MartinSpurs]

Thanks for the info. Very helpful. Got my PSA result today, up from 42 to 135 in a month. Not ideal. RBC very low.No wonder I'm feeling tired!

Interestingly (perhaps?) My Alk Phos continues to drop and is now 301 from 450 in Jan.

Meeting Onco on Thursday and see where we go from there.

Best wishes Nalakrats, you are very generous with your time and knowledge.

Martin

[MelaniePaul]

Hi Martin.

I wonder what decision you have made regarding your treatment?

Personally, I do think you should give Carbo Platin a go. My husband has been on it - now at infusion 9 - and is feeling quite well actually. Much better than on Docetaxol which made him feel very sick most of the time.

So I would say: Try it. You can always stop it side-effects get too bad, but I don't think they should be as bad as the ones on Docetaxol were.

Best wishes

Mel.

[MartinSpurs in reply to MelaniePaul]

Hi Mel

Many thanks for your reply. We are going the Carboplatin route starting on the 21st of May after a weeks holiday in Rarotonga...yay!

Apparently it is mixed with Docataxel so I get both drugs, not sure if that is your experience?

Bit nervous going into it, but I don't have a lot of options Will try and update in a couple of months and let you know how it's going.

Best wishes to you and your husband.

Martin