Starting Radium 223 (Xofigo) next week

[johngwilk]

Having just finished a trial of carboplatin + docetaxel, I'll be starting Xofigo next week as a bridge to a pembro+ trial early next year. My latest PSA is 940, with no visible soft tissue involvement. I have a single-strand CDK12 defect. Hoping that the suggestion of this paper is true for me:

Efficacy of Radium-223 in Bone-metastatic Castration-resistant Prostate Cancer with and Without Homologous Repair Gene Defects

ncbi.nlm.nih.gov/pubmed/302...

[NPfisherman]

Hi johngwilk,

I would ask if Dinaciclib could be added to the Xofigo treatment and might be of benefit--

cell.com/cell-reports/pdf/S...

perhaps it may sensitize the PCa by it's inhibition of CDK12--worth consideration....Good luck....

Don Pescado

[johngwilk in reply to NPfisherman]

Thanks. I'll add this to my discussion list with my oncologist doc.

[tango65 in reply to NPfisherman]

Is dinaciclib approved by the FDA?

[NPfisherman in reply to tango65]

I did not find a disapproval--Phase 3 completed....I am thinking he could try under "right to try" since dosage is established--I could find no other drugs for that mutation.

[NPfisherman in reply to tango65]

I believe that like HIV, what we found was that by adding combos--multi drug therapy--HAART, we were able to achieve improved disease state--CD4's improved, decreased viral loads... with a PSA of 940, and already through prior meds--since it is Xofigo and then a Keytruda + trial, the chance to hit directly at his mutation prior or during Xofigo may give it that added punch to really drive back the disease and THEN...the Keytruda trial...all....IMHO....

Don Pescado

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

Yep Drug Cocktails....(I agree)...

youtube.com/watch?v=lvt4b_q...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 07/24/2019 6:39 PM DST

[CarlinPhoenix]

Hello Johnwilk,

Thanks for your post. I have a similar situation in that I have cdk-12 break. I am being seen at Mayo Clinic. I was able to find a trial at UofM medical center in Ann Arbor MI which is a phase 2 study and utilizing two well known drugs nivolumaub and ipilimaub combined. The recruiting for this trial is for PC patients with the cdk12 only. After two infusions on this trial my PSA went from 55 to 750. I was taken off the trial.

Returning to Mayo I was put on cabazataxil last month. The process of getting on the trial at UofM took six months of NO effective cancer treatment. My cancer has significantly increased.

In 2018 I was put on another off label drug called Lynparza with disastrous results.

The delay of my standard of care options and trying off label and medical trials my PC has extensively metastasized to my bone where it lights up basically all the bones in my body.

I hope your experience with RA223 is successful. I have heard nothing but good things about it especially for those with extensive bone mets. I will also be trying RA223 after cabazataxil myself.

Good luck!