PARP Inhibitors ??

[Fairwind]

Here is a message from my Oncologist...What's it all mean ? Is this good or bad news ??

Your Foundation One just came back. The two findings are that you have AR

(Androgen Receptor) amplification (which makes sense as this is prostate cancer)

and an ATM (ataxia telangiectasia mutated) mutation.

This is actually pretty good news as the ATM mutation suggests that you might have

response to a PARP inhibitor. We have a study looking at a PARP inhibitor

(olaparib) that just opened here at the VA for people with ATM (and some other)

mutations, but they may need to confirm on a non-liquid biopsy. I also am going

to look into seeing if we can get either that drug or a similar one (Rucaparib)

approved off of a study in case they cannot confirm the mutation with your prior

bone biopsy.

[Tall_Allen]

The good new is that you have a mutation that may respond to one of the recently approved PARP inhibitors. The somewhat bad news is that response with the ATM mutation is not nearly as strong or as long-lasting as response with the BRCA mutation. But better some than nothing, and it can vary - you may get lucky. The other somewhat bad news is that the PARP inhibitors may be toxic in some men. This explains more:

prostatecancer.news/2019/10...

BTW, the two newly approved hormonal therapies, Erleada and Nubiqa, are said to slow down AR amplification (which always occurs). While you don't have the type of diagnosis for which they have been approved, my friend was able to get Nubiqa because he had a small stroke. It might be worth discussing with your oncologist to see if he can stretch your diagnosis a bit to get you one of them.

[Fairwind]

Thanks guys, very helpful

[immunity1]

ATM-mutant disease appears to be less responsive than BRCA to PARP inhibition unfortunately..

DOI: 10.1016/j.eururo.2019.02.002

. Free PMC article

[Patrick-Turner]

Tall Allen sums it up better than I can but any use of PARPs can have good or bad outcome.

Men who don't have high Ga68 avidity in PsMa scans will be told Lu177 won't work for them and if all known ADT and chemo has already failed and DNA analysis shows you might benefit with a PARP that suits your DNA profile, then I'd agree with docs wanting to give you Olaparib or whatever else because there may not be anything else you can try.

I wish you the very best of luck,

Patrick Turner.

[Fairwind]

Yes, that's where I'm standing now.. Looking to see if there is some forgotten pill or treatment..I need to check out R-223, compare it to PARP.