What options after doctaxel failed, then Extandi failed after 6 weeks? Any treatments, med centers for consults, clinical trials?

[Barbara345]

Husband was diagnosed with PC with extensive bone mets last August. PSA 49, Gleason 9, no symptoms. Still on Lupron. PSA initially dropped; then went up after 2nd of 5 chemo treatments. Started Xtandi around March 1, PSA dropped and then kept rising. Still on Xtandi for now, scans scheduled next week. Have people used Jevtana, other things, any clinical trials, any other places Barry should consult? Conference with MO scheduled after scans. Hope to come with as much info as we can. Thanks!!!!

[Tall_Allen]

Who is his MO?

Anything useful in biopsy?

[Chugach]

Sounds like a lot of unknowns still and possibly a lot of options. I recommend getting genetic testing of the prostate cancer done, it could point to possibly therapy that could work.

[JoelT]

Most clinical trials have been halted due to the COVID virus. Genetic testing is clearly in order, there are many options like Foundation One. Genetic testing can give you some direction on future treatment possibilities as well as open up the possibility of some otherwise not available treatments.

You did not provide any information about your actual PSA levels or any scanning information.

Who is your doc? Are they an expert on the treatment of advanced PC? Not all oncologists are experts.

Jevtana might work, even if docetaxel failed.

Joel

[paige20180 in reply to JoelT]

HI Joel. Do you know of any ways to get the costs of the Foundation One test down? We were charged $5,600 by Foundation One. Our doctor did not know how much the test costs and we got stuck with this huge bill. Blue Cross would not pay. My husband only showed PTEN loss. I guess 67% of people with tumors have PTEN loss in their tumors. Our MO interestingly thinks my husband has a genetic issue not yet discovered. Thanks.

My understanding is the FO test tests for somatic changes in the tumor. Invite tests for free and was ordered by our MO and their test tests for Germline genetic mutations. Thanks. I'd love any help you may have to get rid of this $5,600 bill.

[AlanLawrenson]

Definitely think that a COLOR genetic test is appropriate. It will signal what newer treatments are likely to be successful.

The COVID 19 may have delayed the conclusion of the major US trial on Lutetium-177 that is likely to see this therapy approved in cases similar to yours.

You might find some benefit by reviewing my latest book available from Amazon.