Well Mike started his 5th cycle today and his PSA has risen the last 2 blood draws. His ALP and LDH has also risen. Is there anything left? I’m pursuing LU-177 but it’s not easy to figure out logistics when you still have 2 young kids at home. Feeling deflated 😕
Cabizataxel/carbo not working - Advanced Prostate...
It doesn’t produce much but it’s gone up from 4 to 6 in the last 2 weeks. If it weren’t for the increased LDH and ALK I might not have put too much thought in the numbers. I asked Dr Aggarwal about running an IHC analysis on the biopsy they took recently but it was a bone met they biopsied and he said the pathologist who do bone marrow biopsies do not routinely run IHC rather they send them for genomic analysis which they performed through STRATA. Again, no targetable mutations.
Well, IHC can tell you if his tumors are PSMA-avid plus a number of other actionable things (e.g. neuroendocrine, somatostatin, AR, PSA), which is not something they check on the genomic analysis. I'm surprised that UCSF doesn't do it routinely. I see the Lu-177-PSMA-617+Keytruda trial at UCSF was suspended due to drug availability - do they expect to re-start it?
If his scans show most of his mets are in his bones, then Radium-223 (Xofigo) works well for many patients. BAT might be worth a try ..If nothing else, it tends to "reset" the cancer so Zytiga works again. Provenge might be worth a try..These things should keep him going until they approve LU-177..Sometimes with the Cabazitaxel they add a platinum chemo agent which seems to work better than Caba alone..But the R-223 might be a better choice depending on how his scans look..
I’m working on it... I think we could tap some resources and swing it. But I’d hate to spend the money only to find the treatment didn’t work at all. He’s well enough I think to travel alone but gets easily flustered/ stressed out these days and imagine the travel would really put him on edge. So much!