Advanced PCa options. Prescribing do... - Advanced Prostate...

Advanced Prostate Cancer
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Advanced PCa options. Prescribing doctor disagrees with Specialist


I posted here the other day that we received amy dad‘s testing from Guardant. It showed high RYP amplification. It also showed .02% BRACA mutation. His regular MO recommends getting into a phase 1 for the RYP amplification.

Yesterday we had a phone consultation with Dr. Lam at Prostate Oncology. Dr. Lam was excited by the very BRACA mutation and recommended Lynparza. My dad‘s regular MSO thinks this is ridiculous suggestion and refuses to prescribe it.

Again I am racing the clock and feel completely stuck.

9 Replies

Same exact boat here. 🙏

Find someone who will prescribe it. Some doctors refuse to think outside the box. Or, work with Dr. Lam. Have him prescribe if possible.

Lynparza, and Olaparib are used for BRCA mutations---someone does not know their stuff. but to use these requires approval--as they are off label for Pca---and would probably not be paid for, unless in a trial.


He has a microscopic amount of BRCA2 mutation, so I agree with his MO that Lynparza would be a very poor choice at this time. It is very toxic and would have no benefit. I'm frankly surprised that Dr Lam would advocate it. On the other hand, he has high RYP amplification and a clinical trial to address it. His MO sounds terrific!

While Lynparza would be foolish now, genetic breakdown continues over time, so you can do another Guardant analysis after the trial to see if there might be any benefit to it later.

Regarding Lynparza trials that will pay for this drug, UC Davis Sacramento has one. Trial number NCT02893917. Must have a tumor that can be biopsied again. Mutation not required to qualify because it is tested with another drug together.

Good Sunday Morning Damusolf,

While under the care of Dr. Snuffy Myers, a Guardant360 liquid biopsy revealed ATM defect and Myers prescribed Lynparza.

It was covered by my Medicare D plan and worked for about 9 months.

Best wishes. Never Give In.

Mark, Atlanta

Very little BRACA, need to worry about/treat other 99.98% of Pca. Sorry to sound harsh. Good luck with Drs. and treatments.


So does it make more sense to get into a clinical trial for the RYP or just move on to another treatment like lutetium if possible?

dadeb in reply to Damusolf

We have a consult with another MO for another opinion in the morning. I’m hopeful we’ll both find something hat will fight the cancer. I’m I’m ordering the BIRM that nalakrats suggests. I’m using several other natural supplements to help with the anemia caused by Radium 223. Keep us all posted if you get news.

Here’s to hoping. 💗

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