Lynparza? Mixed blessing.

[Drcrunch]

After 9 months on lynparza for Brca 1 pc, developed moderate anemia. Scan shows reduction in bony Mets, which is good, but now have Mets in liver. Not good. Still have no pain. Ten years out and still have not had chemo. I guess that is next step. Anyone else with liver/? I guess the longer you survive the more chances for visceral Mets. Psa never dropped while on parp inhibitor(. (Psa over 2000 last 9 months)

[Tall_Allen]

Usually, carboplatin works when a PARP inhibitor works - it may shrink the liver mets. Depending on where they are, and how localized, radioembolization may help.

[Roast85 in reply to Tall_Allen]

Hi Tall Allen, I'll be starting Lynparza as soon as I figure out how to get co-pay assistance from somewhere. The application has been submitted to Astra Zenica as of yesterday so I wait. The copay is over $2600 for 120 pills (ouch). The cancer has spread into my liver quite aggressively at 60% but my MO is reluctant to recommend radioembilization, stating it would expose me to excessive radiation, due to the amount of cancer which is present in my liver.

Foundation One has found that I do not possess the BRCA2 gene in the liver tumor, taken in a biopsy. As a result, Foundation One thinks Linparza is a logical treatment, as does my MO.

I'm just not sure about the MO's opinion that radioembalization is not a good choice and his reasoning. Any input will be most appreciated. Thanks!

[Tall_Allen in reply to Roast85]

He is quite right. Radioembolization can only be used when there is limited tumor infiltration in a peripheral location. It is a very localized treatment.60% is too much. Lynparza sounds ideal.

[Roast85 in reply to Tall_Allen]

Thank you so much Tall Allen. I really do like my MO a lot but I appreciate your input and will proceed with the Lynparza, assuming the financial assistance is there.

Unfortunately, due to my bone marrow issues, we are concerned about my blood cell counts and will start me on a 25% reduced dose of the Lynparza. This marrow issue also rules out platinum chemo or any chemotherapy at this stage.

As it is, I have required transfusions regularly since last May.

Take care and thanks again!

[Roast85 in reply to Tall_Allen]

Also, have you ever heard of someone not having a BRCA2 gene at all? I don't mean a BRCA2 gene mutation. I mean that I don't have the gene at all, mutation or not?

Thanks!

[Tall_Allen in reply to Roast85]

I saw that you wrote that and it surprised me. As you said, usually there is a mutation (SNP change or deletion) that makes the BRCA gene useless to repair DNA. This is the first I heard of the whole gene being deleted.

[Roast85 in reply to Tall_Allen]

That's what my MO said. My understanding is that it should be essentially the same as a mutation, in terms of Lynparza potentially being effective.

[cbgjr]

BRAC2, I've been on a PARPi + CHECKPOINTi trial for about 5 months. I too experienced anemia, which was resolved by reducing the PARPi by 25%. The disease progression was halted, no new mets and the affected lymph nodes are shrinking, so something is working. But interestingly, as in your case, the PSA didn't drop much, it stayed the same as at the start -- hovering around 18-20. However, the ALP did drop and now it is as low as it was before the PCa.

Sorry about you liver mets, hopefully they can be resolved as some of the other repliers have suggested.

CG

[Hidden]

Good to see you post again . The liver is scarey . I’m sorry about that .. after ten years 2000 is wildly crazy.. I’m five years in undetech and we know that pc doesn’t leave the host In time ... I have yet to do chemo either .. If that your choice may it work well . What a life??? I’m glad you don’t have pain . That is a blessing .. Take care dr. 😂🙏

[Drcrunch in reply to Hidden]

Nice to hear from you

[Hidden]

Thank you . You also . You are sure and steady ... I see no fear in you .

[j-o-h-n]

Keep on keeping on.......

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 10/15/2019 7:18 PM DST

[vandy69]

PCa mets found in liver in September 2017 and immediately began chemo with Docetaxel/Carboplatin combo. Now on third round of this treatment (2 rounds of 6 cycles previously) and it has worked for me. After each of the prior rounds of chemo did a rechallenge with Xtandi which worked for about 6 months. During this 3rd round of chemo, am simultaneously taking Xtandi.

Best Wishes. Never Give In.

Mark, Atlanta

[Drcrunch in reply to vandy69]

Nice to hear from you