Immunotherapy trial as inaugural treatment for mHSPC.

[Namork]

This is my first post on this forum but over the last month or so I have spent a considerable amount of time going through your stories and advice. Thank you to all members for forming this invaluable forum for PC patients and their families. I want to contribute back what we have learned in the few long weeks since my father's initial diagnosis of mHSPC.

My father, 57, has been diagnosed with mHSPC in late November through a biopsy. He has had rising PSA for the last three years during his annual check-ups (6 three years ago, 9 two years ago, 23 in November and 32 as of late December). His biopsy came back as Gleason 8 (4+4) and later we found out that he has 8-9 mets in his lymph nodes (2) and bones (6-7) including the pelvis, spine and ribs.

We are lucky to be based in NYC and have access to some of the top cancer institutions and experts in the world. Through a lot of references in this forum we ended up getting consultations with Dr. Oh (Mt. Sinai), Dr. Morris (MSKCC), and Dr. Drake (Columbia-Presbyterian) as we were in the process of evaluating the initial condition and waiting for test results to come back. The biggest take away is that the standard care protocol (ADT & Chemo / ADT & oral hormones) was suggested unanimously by all doctors citing the big three studies (CHAARTED, LATITUDE, and STAMPEDE). Radiation and surgery were no longer options outside of palliative treatments down the road.

We're of the thought that we want to hit this disease as hard as possible in the first run while it's still hormone sensitive. Dr. Drake told us that he is currently running an immunotherapy trial for mHSPC patients which will give us standard care (ADT & Docetaxel) to the addition of PD-1 blocker (Cemiplimab) which has been FDA approved for other sorts of cancers. The trial only accepts patients who have yet to receive treatment and more details can be seen in the link below.

Trial here - clinicaltrials.gov/ct2/show...

We consulted with Dr. Morris and Dr. Oh about the trial and both of them thought of it as a good option for our situation. We have elected to participate and are looking to receive the ADT first injection this Friday (1/10).

I want to put this information out there in case anybody else would be interested as we were lucky enough to talk to a doctor that has a trial for castrate-naive cancers for those looking for something beyond standard care. Further research lead me to believe that most trials are for castrate-resistant stages and this may be the only trial in the country that fits our situation.

I know it's going to be a long battle ahead but we have come closer as a family and will take this fight head on. We draw inspiration from everyone that came before us and those currently walking the same road with courage. Health to you all.

[Tall_Allen]

The combination of chemo and immunotherapy is IMHO a very good idea. The immunotherapy augments the immune response that chemo diminishes. At the same time, chemo releases cancer antigens that the immune system can then learn to target. The hope is that there will be a sustained abscopal effect where the T cells are programmed to search out and destroy cancer cells everywhere. That's the theory, at least. I hope it works for your father. Please let us know.

[Namork in reply to Tall_Allen]

Thanks Allen, will do.

I want you to know that I have used your blog extensively in the process of educating myself on the topic of this disease. It has led me to make better informed decisions and your are a benefactor to people fighting for their lives, thank you for that.

[Dd7757]

Wow! How lucky your father is to have such a bright, articulate family member on his team.!