"Unfortunately, he developed progressive bone marrow failure, a common development in men with uncontrolled prostate cancer. His production of red blood cells was so impaired he could only be kept alive with monthly blood transfusions. When the Xofigo was stopped in August 2014, the PSA had risen to over 120. Bill's chance for living another six months were less than one in 10.
Up to this point, another doctor was managing his case. Right before he switched supervision of his medical care to my office his previous physician started Bill on an off-label medication called Mekinist. Mekinist is a pill that is FDA-approved for metastatic melanoma. Since use for prostate cancer (off-label use) is not covered by insurance, Bill purchased the pill himself at a cost of $10,000 per month. However, his investment paid off. By December 2014 the PSA dropped to 18.96, his bone marrow started functioning again, and he no longer needed any further blood transfusions".......
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JLS1
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There is a clinical trial underway - concludes January 2021. " Trametinib in Treating Patients With Progressive Metastatic Hormone-Resistant Prostate Cancer" NCT20881242.
The benefit of this site is that the collective knowledge present at the site is huge. Not heard of Mekinist here or elsewhere before. It is what my brother needs right now as his bone marrow is under very serious PCa attack. He is fading fast with no further therapies other than pain management, being offered. His access to compassionate use of Veyonda was rejected by his oncologists.
I'm so very sorry to hear about your brother. Are you 100% sure it PC in his bone marrow and not at least partially a side effect from treatment? Did he have a bone marrow biopsy?
It's hard to believe there isn't any CRPC treatment for bone marrow invasion?? I did find a couple cases where Xtandi + Xgeva brought relief, and one where Keytruda worked miracles, and the Mekinist.
I read some of your other posts and the Veyonda sounds very promising!! Wish it could be available here in the US NOW!! Does it have to be given with RT to work?? Is there any way to give it so that it can work systemically?
My husband may be in a similar spot after his bone marrow failed a couple weeks after his 4th Xofigo injection (hemoglobin suddenly went down to 6.1, platelets to 53) and a transfusion of 3 units of RBC's didn't 'take'. (brought him up to 'only' 8.4, platelets to 57, but then 10 days later he was back down to 7.7) 9 days ago (3 weeks after his first transfusion of 3 units of RBCs) his hemoglibin was down to 6.7 and platelets at 38, so they gave him of 2 units of RBCs that apparently isn't taking either (per blood test 6 days later - hemoglobin at 7.7, platelets at 44) , so oncologist feels its due to cancer invading his bone marrow. He said there's a very slight chance it might be side effect of the Xofigo (and I'm thinking esp since he was on Lynparza right before he started Xofigo, since Lynparza depresses bone marrow) We know it's not unusual to require transfusions to get through all 6 treatments, so we were shocked when the oncologist said there's nothing more he can do now, and that he's 'willing' to give blood transfusions, to support him, for a while. I read someone else on this board was in the same spot and his bone marrow finally recovered after 2 months and several transfusions, so we're NOT giving up hope (as our Dr and his nurse seem to want us to - GRRRRR!!!!!!! Seems like they're throwing in the towel!! )
If cancer is in the bone marrow, shouldn't it also be in lymph nodes? My husband doesn't have it there, per CT scan done 13 days ago, or anywhere else new, and his only physical symptom now is fatigue - from severe anemia, and from severe emotional stress due to what MO told him - horrible bedside manners!!
I hope we can find encouragement, somewhere, for your brother and my husband, as well as all others in this situation!!
Yes, dealing with MO's is very frustrating. Sadly, by the time I found a MO who would authorise Veyonda , it was just too late. The PC in the bone marrow is extensive and growing daily, with blood parameters deteriorating. Veyonda was recommended for my brother as a monotherapy. He had had SBRT 6 weeks earlier. Noxopharm use Veyonda with RT as their standard therapy. A new Phase 2/3 clinical trial will start around March in a number of countries including the USA.
I wanted him to have a genetic test, but the time to get the kit, return it to Color to check whether he has the MSI - H repair gene fault would take too long. This would have allowed him access to Keytruda, which is effective in this situation.
I feel for you at this time. Any chance of getting Mekinist?
The insidious nature of PCa is such that you cannot take your eye of the ball for even a minute. There were things that my brother should have done when his pelvic pain appeared about 14-16 weeks ago. Immediate return to Xtandi or a start with Docetaxel at that time would have seen him keep the disease at bay until something better might become available.
I feel particularly frustrated as I have written three books on PCa and consider myself very well informed on the subject. Clearly, there is much that I still have to learn.
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Oligometastatic PC and Radiation
DIC? 
Gleason 9 (5+4) 10+ years ago - widely metastatic cancer and running out of options!
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