Abiraterone and Doxatecel Failed - what next I wonder

[deedeer]

Any info anybody can share would be very much appreciated, here is my history

dropbox.com/s/salo2ajfuo7jv...

[Tall_Allen]

deBono is excellent! He is also plugged into almost every important clinical trial in the UK. Approved drugs include Xtandi, Xofigo, Jevtana and Provenge. in trials, there's a Lu-PSMA-617 trial at Royal Marsden, estrogen patch and several immunotherapy combinations.

[deedeer in reply to Tall_Allen]

Thank you so very much tall Allen, i really appreciate your positive prompt reply. It sure is a worry. Thank you again

[AlanMeyer]

Tall_Allen has listed the main treatments that are available for the next attempt. The one that has particularly interested me is the Lu-177 PSMA treatment, one form of which is in the trial that Allen cited. It uses a molecule that binds to PSMA and carries a radioactive atom with it that can damage or kill a cell that has PSMA on its surface - something frequently found in prostate tumor cells and rarely found elsewhere. As I understand it, the treatment is not a cure but the majority of men treated with it get some benefit and some get a great deal of benefit. One man reported here that his PSA was still very low two years after treatment. If your PSMA scans showed a lot of PSMA in your body, that indicates a lot of targets that will be sensitive to the treatment and a lot of potential benefit. Very importantly, being resistant to ADT and chemo means nothing at all in regards to this treatment. Your existing drug resistance is not a resistance to Lu-177 PSMA.

Here's a link to a web page and video describing the treatment:

endocyte.com/pipeline/advan...

If the Lu-177 treatment is unavailable to you (though you may be able to get it in Germany if not in the UK) or not considered likely to work, the other treatments that Allen suggested are still possibilities.

Best of luck.

Alan

[deedeer in reply to AlanMeyer]

Thank you also so very much Alan, the members here are just amazing.

[whatsinaname in reply to AlanMeyer]

Hi Alan,

If one wants to do Lu177-PSMA-617 after docetaxel, should there be a certain number of days that should elapse before commencing the treatment ?? Like say 90/135/180 days ??

If there should be a waiting period, can one start on Zytiga + Predinose for that period ?

Many thanks for any answer you may care to give. Cheers !!

[AlanMeyer in reply to whatsinaname]

I don't personally know of any reason why radionuclide treatment (e.g., Lu-177) should interfere with either hormone therapy or chemotherapy, or why those treatments should interfere with radionuclide therapy. I would think that, if anything, the combination of treatments would be extra effective in the same way that Lupron + docetaxel is more effective than Lupron followed later by docetaxel.

If you get Lu-177 as part of a clinical trial, they very likely will require a waiting period after other treatments. The reason is that they're not just treating you, they're also trying to find out how well the treatment works. If you're getting another treatment at the same time, they won't know whether changes in your disease status or any side effects that you get are due to the new radionuclide treatment or to the other one.

Doing a bit of Googling, I do see that patients for radionuclide therapy need good renal function, i.e., they should be able to drink lots of water and their kidneys should work well to pass it out of the system so that radioactive molecules don't circulate around longer than necessary in the body.

HOWEVER! I am not any kind of expert and the doctors performing the radionuclide treatment have to be consulted for an authoritative answer.

Alan

[whatsinaname in reply to AlanMeyer]

Thanks, Alan, for the answer. Your insights into the need for a good renal function is particularly important.

I am an Indian based in Bombay (Mumbai) and therefore will not be in any clinical trial in the US or elsewhere.

[deedeer in reply to AlanMeyer]

Thank you Alan, my renal function has been good, just waiting for copy of last blood test results done on 7/2/19. Apart from the awful Chemo fatigue and streaming eyes I feel remarkably well, which is wonderful.

[Ssiddy in reply to AlanMeyer]

Have a look at the london clinic for LU 177

[deedeer in reply to Ssiddy]

Thank you Ssiddy I will do that. My next step will be an appointment at Royal Marsden in Sutton Surrey with Prof de Bono regarding trial treatments and I will take it from there.

[j-o-h-n]

deedee's HISTORY:

My Prostate Cancer story as at Feb 9th 2019

Hypopituitarism following pituitary tumour removal Aug'94 with hormones replaced

manually from Aug'94.

Oct'12 PC diagnosis initial PSA 10.1 Gleeson 3+4=7 T2b NO MO.

Treated with low dose branchytherapy Jun'13.

PSA fell after treatment then started to rise again by late 2015 it had risen to 41.

Testesterone blocked Oct'15 and PSA again fell down to near zero by early 2016.

But started to climb again and in Apr'18 a PSMA PET scan confirmed spread to Bone

and lymph nodes.

Treated at Royal Marsden Chelsea with Abiraterone for 5 months, May'18-Oct'18, an

Oct'18 PSMA PET scan showed treatment had failed, cancer had spread, and Doxatecel

started Nov'18 but PSA still rising, up to 1700.

Next PSMA PET scan done Feb 6th 2018 and it shows cancer has continued to spread

and so Doxatecel has been ceased.

Now awaiting appointment to see Prof de Bono at Royal Marsden Sutton to explore trial

treatments.

Any thoughts anybody?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 02/10/2019 6:49 PM EST

[j-o-h-n]

to deedeer:

Would you be kind enough to tell us your age? Thank you.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 02/10/2019 6:54 PM EST

[deedeer in reply to j-o-h-n]

Hi J-o-h-n, I'm 67. Diagnosed with PC at 61 in 2012.

[j-o-h-n in reply to deedeer]

Thank you.... Keep Plugging away....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 02/11/2019 12:56 PM EST