Keytruda Next?

[vandy69]

I have been in this battle for 6 1/2 years, with every drug, proton beam radiation, and now second round of Docetaxel/Carboplatin chemo. PSA is on rise after 4th infusion, from 2.5 to 3.1, so first line chemo may no longer be effective. Med Onc is considering Keytruda off label if we can get it financially covered.

Thoughts from TA, Nal, and Patrick (and others) on this approach. Do not yet know if I am PSMA positive.

Thanks.

Best wishes. Never Give In.

Mark, Atlanta

[cesanon]

1. What is the thinking behind using keytruda for this particular type of cancer?

2. Why would you not try a psma type of treatment first.

3. Have you investigated bipolar testosterone treatment?

4. This is a new investigational use of Keytruda, if your doc is willing to write it up and publish what happens, perhaps the manufacturer may give him some free or low cost investigational samples. If you contact them directly, they might even refer you to one of their favorite Docs, whom they like and whom they are more willing to do this. It might even be that Darryl can help contact the manufacturer.

[vandy69 in reply to cesanon]

Hi cesanon,

Thanks for prompt reply. To answer your questions:

1. Will have discussion with Med Onc after 6th infusion and liver MRI. Earlier Guardant360 liquid biopsy revealed ATM defect, so have already used PARP inhibitor Lynparza. Prostate cancer invaded my liver in September 2017, hence Carboplatin added to Docetaxel.

2. If PSMA positive, would look for PSMA 617 Lutitium 177 availability in US.

3. Famous New Orleans Med Onc used me as a lab rat with high dose T via AndroGel applied to upper arms. Wanted T to reach 1000, but I could not get there. In meantime, PSA rose from 4 to 20 and then liver was invaded. Coincidence?

4. Med Onc has had some success with drug manufacturer supplying Keytruda for free in off label use. Also have a specialized drug plan, which could assist.

Maybe Jevtana next?

Thanks again.

Mark, Atlanta

[cesanon in reply to vandy69]

Mark, is that Sartor?

I use him. I am thinking about using him for bipolar testosterone for next round of treatment.

Was it bipolar testosterone, or just straight testosterone?

Why did you just use androgen? Aren't there far more effective ways to raise testosterone?

Sartor really favors straight testosterone. Do you think I will have any problems getting him to do bipolar?

By the way, I choose him specifically because he is willing to lean forward, like Dr. Myers. It is easier to be conservative with an aggressive doc, than vice versa.

[vandy69 in reply to cesanon]

I was very surprised at using AndroGel instead of a injection. In hindsight, I believe we should have gone straight to chemo without this experiment that gave my cancer an unneeded boost, as PSA rose from 4 to 20 in about 6 weeks and then it showed up in my liver.

Be cautious.

Mark

[Tall_Allen]

Is that Sartor? If he can get you Keytruda, why not try it? It has not tested well for PC (except for rare MSI-Hi/dMMR), but, who knows, you may be the exception. Be cautious about radiation of any kind (including Lu-177-PSMA-617) with your known ATM defect, if it is germline and not just somatic (I'm not sure if Guardant360 is specific to somatic mutations). It's probably targeted enough so there won't be a problem, but I think it would be prudent to start with a lower dose.

[j-o-h-n]

As I've posted before and before and before... I'm being treated for stage roman numeral IV lung melanoma (not offshoot of Pca) with Keytruda. It's worked for me so far (15 injections @ $30K an injection). I asked both my Pca and melanoma oncologist about it's use for Pca. Both of them said at this point (last year) it's not effective. Hopefully that has changed, so:

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/21/2019 6:56 PM EST

[joann48 in reply to j-o-h-n]

Do you need the BRCA gene for Keytuda ?

[j-o-h-n in reply to joann48]

joann48.... you got me there. I will have to message my Melanoma Oncologist and if she replies I will let you know....Sorry I can't answer that question now.... I won't forget to let you know.... Hopefully she will respond.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 07/11/2019 7:25 PM DST

[j-o-h-n in reply to joann48]

to joann48 copy of message to doctor)

Hello Doctor,

Someone recently asked me this question and i do not know how to answer it. Here it is:

"Do you need the BRCA gene for Keytuda ?"

Would you please be kind enough to answer it.

Thank you,

Hopefully Jack and Olivier are enjoying the summer.

John

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 07/11/2019 7:35 PM DST

[Longterm101]

Did u ever try the Keytruda ?

[vandy69]

I have not yet tried it. Think next step will be chemo with Jevtana, but need to get stronger.