Pembro and Olaparib clinical trial

[PAQFAS]

Gents-request thoughts please. Advanced prostate cancer patient. Have been on Zytiga about 2 years and PSA had been undetectable but now going up, still low 2.1 but doubling every 6 weeks. Exploring options to get ahead of it. Consult at Johns Hopkins offered Pembro and Olaparib combo clinical trial . I did not have BRCA1/2 or ATM gene mutations and not sure of efficacy of this trial for me. Have read of adverse effects of those on trial. Weighing pros/cons. If I don’t do trial, next standard of treatment is enzaludimide. Request thoughts on options. Thanks.

[Tall_Allen]

Results of olaparib for men lacking BRCA mutations have not been good:

pcnrv.blogspot.com/2019/10/...

Pembro only seems to be beneficial in men with MSI-hi/dMMR

What were the results of your metastasis biopsy?

[PAQFAS in reply to Tall_Allen]

Biopsy 2,5 years ago 3+4=7. All cores and scans indicate seminal glands involved. Back L1 biopsy positive. No gene mutations in 12 tested. Initially on PROSTVAC clinical trial at NIH, but stopped when PSA rose out of limits. Put on docetaxel for 2.5 infusions then stopped due to adverse effects. Then to Abby for 2 years and grateful for body response. Now PSA rising. Your thoughts appreciated Tall Allen.

[Tall_Allen in reply to PAQFAS]

When you say "No gene mutations in 12 tested," what test are you talking about? Was that from an IHC test of the L1 biopsy? Was it positive for PSMA? PD-L1? Have you had any PET scans? Have you discussed Xofigo (perhaps with Provenge)?

[greatjohn]

I'm two years in (almost) on Xtandi...and my PSA has slipped up to 5.34 ~~I wish they would talk to me about this trial. It sounds promising.

gJohn

[PAQFAS]

Nalakrats - have not had scans for a year - due in January. Trial requires another baseline biopsy and appears best outcomes targeted at specific gene mutations which my tests showed none. I’m of mind, like you, to see where I am scan wise before committing to JH trial or other course of action. Enza next standard of care for me but open to aggressive or other options that can sensibly provide best outcome. Thanks for your thoughts on darolutimide or orleada. I’ll research them. . Thanks for your thoughts!

[ArabianNights]

Hello.

I am curious as to what you decided. I am trying to make the same decision for my father. PSA doubling quickly.. 6 weeks as well. He also didn't have the BRCA gene mutations.

[PAQFAS in reply to ArabianNights]

Thanks. Didn’t decide yet. Will consult with doc this month, sked scans, see where I am scan-wise before deciding . Need to know more about trial and effects and my condition and other options. Lot I need to learn and know. Blessed with a informed sharing partners here. Best wishes to you and your dad.

[Peterd110 in reply to PAQFAS]

Keep us updated on what the doc says