Genetic testing results

[Dan59]

I am wondering if anyone knows what these reslts mean? I have read that ar L702H which I have can be caused by prednisone and possibly switching to dex would allow zytiga or xtandi to work, Thank You

[cesanon]

If these are the results of genetic testing it would seem unlikely that taking Prednisone or any medication would cause these results.

[Dan59 in reply to cesanon]

Cesanon, This is where I got that about AR L702H being caused by prednisone. Just hoping Tall Allen had some info. mycancergenome.org/content/...

[Tall_Allen in reply to Dan59]

"Damaged" androgen receptors are capable of getting switched on by a variety of atypical ligands. Corticosteroids are usually able to suppress AR activity, but at some point, they become corticosteroid resistant. I've seen the study where dexamethasone worked after prednisone failed with abiraterone. It may be worth a shot:

ncbi.nlm.nih.gov/pubmed/300...

[Hidden]

Dan,

You might want to wait until someone who knows without question exactly what your results mean before assuming anything. I do see a lot of green check marks for go, so I'm sure some good will come from your testing.

[Dan59 in reply to Hidden]

I have an appointment with the MO weds, just wanted to get as much info as I can before going in, thanks Bill.

[Hidden]

What I saw was a problem with prednisone and enzalumatamide with the ARL702H mutation. Here's the quote:

If patients are receiving corticosteroids, this does not preclude the use of enzalutamide. If a clinician chooses to use corticosteroids with enzalutamide, this should be according to the clinical need (eg, palliation of symptoms). Use of corticosteroids without a clear clinical rationale should be discouraged due to the proposed mechanisms in which corticosteroids may confer resistance to enzalutamide. One proposed mechanism involves corticosteroids outcompeting enzalutamide for binding of androgen receptor target genes in tumor cells that express an androgen receptor carrying the ARL702H mutation.

Source: sciencedirect.com/science/a...

The primary completion date for ARASENS trial with ODM-201 (Darolutamide) is mid-September. Darolutamide appears to be effective against AR mutations so that may be an option for you. Hoping you find a good treatment and thanks for sharing this with us.

[Hidden]

I have not found anything on effectiveness of Apalutamide with AR mutations. If anyone has a source to article(s), please post. Thanks.

[Dan59]

Thank You for your research Gregg, I will print this out and bring it to MO weds.

The more I am reading that prednisone can cause this mution that causes resistance to zytiga and xtandi I have 2 thoughts

1. This could be the reason for the observation that sometimes when zytiga fails switching to dex can ilicit response, could be that the prednisone was causing the AR L702H mutation.

2. Another good reason to do just 5mg prednisone with initial zytiga.

[DeanNelson in reply to Dan59]

I am new PCa and they started me on Zytiga 1,000mg and just 5mg prednisone

[lincolnj8 in reply to DeanNelson]

That is working for me. Remember, no food 2 hours before taking Zytiga and One hour after. Hot flashes are fun but no big deal. I'm on Lupron also. Have to watch the bones with this one. I get an infusion monthly (for the bones) and take Oscal (a vitamin D supplement) twice a day plus a multiple vitamin. Been at this for 8 months now and the PC is on hold. Feeling great. I've been cutting trees and splitting wood for the wife and I for the winter. Doctor advised that I shouldn't lift anything really heavy due to possible bone fractures. I'm 67 and was diagnosed 9 months ago. And what a surprise that was at Christmas. Listen to your MO. Good luck.. By the way, I was scared too. Stage 4, spread to the bone, lymph nodes and everywhere else. Laying in the hospital getting blood a week before Christmas, never a sick day in my life. That Zytiga and Prednisone put me back on my feet, Psa went from 800 down to 1. I'm in total remission. You will be too..

[Daddysdaughter]

My fathers results showed the same- basically nothing available...

[erjlg3]

How is everything going Dan? What did doc say? You doing okay? We're you able to get answers from doc that you were comfortable with? Thinking bout ya. Any more traveling to come soon?

Hugs,

🌼Jackie

[Dan59]

Hi Jackie, I am doing ok. I am trying to get my blood numbers up right now so I can qualify for the lu177 trial. 20 rounds of chemo has knocked them back. I am at home with family trying to enjoy every day.

Thanks for thinking of me, it means a lot.

Dan

[Dalph87]

Dan, just read through your bio, amazing stuff.

Sadly I don't know much about genetic testing but I was wondering if you tried Provenge and rechallenges of Zytiga and Xtandi after your chemo sessions.

Good luck with Lutathera, I read many good things about it and I'm sure it'll benefit you, hopefully my father will have it soon as well.

Best wishes.