PRINT

[pjoshea13]

New video from Dr. Oh [1]. Trial description: [2]

PRINT is a lousy name for a study because you can't just Google <PRINT> & expect good hits.

The alternative is to Google: <Prostate Cancer Intensive, Non-Cross Reactive Therapy>. LOL

Two interesting things in the study: (i) pairing therapies & (ii) the 3-month limitation.

The latter reminds me of what I was doing until recently, which was to be castrate for 3 months & then quickly bring testosterone up to 1,000 ng/dL for 3 months. My aim was to not only avoid resistance, but also to reverse it. A cousin of BAT; I switched to a sibling of BAT in 2018.

Resistance to treatment begins on day one. The sensible approach is to pair a treatment with a drug that inhibits the escape pathways. Alternatively, at least to add a therapy that has a completely different target - to get a better kill result.

If we know that the median time to resistance is 9 months, say, perhaps it is better to switch therapies after 3 months?

My wife is on Revlimid. When she asked her oncologist how long she would have to be on it, he said "Until it stops working." Sounds familiar. Maybe by the time that one is treatment-resistant there will be a drug to target treatment-emergent cell types?

-Patrick

[1] youtube.com/watch?v=2XfSeAz...(Not working as expected?)

[2] clinicaltrials.gov/ct2/show...

[cesces]

"The latter reminds me of what I was doing until recently, which was to be castrate for 3 months & then quickly bring testosterone up to 1,000 ng/dL for 3 months. My aim was to not only avoid resistance, but also to reverse it. A cousin of BAT; I switched to a sibling of BAT in 2018."

How did that work for you?

How does it differ from bat?

[pjoshea13 in reply to cesces]

At 16 years I am still hormone-sensitive.

It differs in that I use DES.

-Patrick

[PhilipSZacarias]

I like the strategy but Dr. Oh said at the end that the goal was to achieve the maximum kill rate, which according to evolutionary theory is not the goal. Alternating therapies and their timing is predicted to prevent the formation of resistant clones through selective pressure. A stable population of hormone sensitive and resistant clones is the best scenario, actually. Because Ra 223 is selective for bones and does not act on visceral metastases, it be better to pair abiraterone or Enzalutamide with another chemotherapeutic agent - perhaps cabazitaxel (limited studies available) or immunotherapy (PD-1 or PD-L1) or BAT, etc. Cheers, Phil

[RJ-MN]

Patrick, my wife is on Revlimid as well - also combined with Daratumumab, Ixazomib, and dexamethasone on a Mayo clinical trial. Now entering her 12th month, she has achieved a "stringent, complete remission." I wish Mayo's Genitourinary Cancer Dept. was as sharp as its Hematology Division!