Starting olaparib

[Goldberg]

Starting olaparib today. I have Mets to my bones and lymph nodes. One oncologist had recommended Ra223. The oncologist at UCSF who is recommending the parp inhibitor. Is not recommending Radium 223. Anyone have any input/ comments would be appreciated.

[NPfisherman]

Do you have a BRCA 1/2 mutation? Individuals with that mutation benefit from PARP inhibitors....

Fish

[tango65]

If the germline or somatic genomes are positive for BRCA 1/2 mutations Olaparib has a positive response in 75-80% of the patients. With other mutations such as ATM is not very effective in patients with PC, I believe it could be administered with Ra 223. I guess the doctor is not recommending Ra 223 because he is asking you to enter a clinical trial and Xofigo is not allowed.

[Goldberg in reply to tango65]

It is not a clinical trial. He thinks that my reaction to olaparib will be fairly good as I am brica2. And he would rather not use Radium 223 at this point until he sees my reaction holding back the us of Radium until it is needed.

[tango65 in reply to Goldberg]

Your doctor is right, the chances of a good response to Olaparib is very high in your case. However the mean progression free survival is measured in months when used alone.

ncbi.nlm.nih.gov/pubmed/307...

I do nto know if there are data about the use of Olaparib and Xofigo. There is a clinical trial recruiting patients for Olaparib plus Xofigo.

clinicaltrials.gov/ct2/show...

Best of luck.

[Tall_Allen]

Do you have a known DNA repair defect? Why is he not recommending Xofigo?

[HopingForTheBest1]

I am also BRCA2+, based on genetic tests from Color and Foundation Medicine. Also have PTEN, ATR and TMPRSS2 alterations.

I was on Zytiga and Prednisone for just six months before it started to fail, as my PSA rose from 0.12 to 055 in 3 months. My initial PSA at diagnosis in June 2018 was 20. Was switched to Olaparib, and my PSA is now at <0.01 after 3 months. I did have Provenge treatment in March/April, which I have been told does not affect PSA. Also on ongoing Lupron and Xgeva (for bone strength).