After chemo and zytiga

[Cynthgob]

My husband has had chemo docetaxel in 2017. He was in a clinical trial that offered ODM along with the chemo. Unfortunately he was given the placebo instead of the ODM. He has now had a good 20 month on zytiga and it may be failing. Psa slowly creeping up to 7.30. Scans still fairly good as no organ involvement.With the Right to try law would the ODM be a solution? Or is he past that now that the zytiga has failed? Thank you!

[tango65]

Discuss treating him with cabazitaxel chemo. It seems it is a better choice to have chemo after failing one of the new anti androgen instead of using another anti androgen.

He could also discuss getting a PSMA PET/CT and if the cancer is PSMA positive, then he could consider a clinical trial for Lu 177 PSMA or if financially possible get the treatment abroad with Lu 177 PSMA and/or Ac 225 PSMA .

He could request treatment with Provenge and getting a liquid biopsy to see if there are mutations which could be treated with olaparib, rucaparib and/or keytruda.

Some clinical trials for PET/CT and Lu 177 PSMA:

clinicaltrials.gov/ct2/resu...

clinicaltrials.gov/ct2/resu...

clinicaltrials.gov/ct2/resu...

[Tall_Allen]

If it was ODM-201, it sounds like the ARASENS trial he was on., it has now been approved for non-metastatic castration-resistant PC as Nubeqa (darolutamide). It is in clinical trials for other uses. It can be prescribed off-label, but insurance will probably not want to pay for it.

I think it is best to alternate chemo and advanced hormonals:

prostatecancer.news/2019/12...

Xofigo+Provenge would also be a good choice.

[Magnus1964]

He is still responds to ADT drugs so don't focus on darolutamide (ODM), it's still is in phase I-II trials. He might consider another ADT drug i.e casodex, xtandi etc.

[Cynthgob]

I was just interested in the right to try law and how that worked.

[HopingForTheBest1]

Zytiga/Prednisone failed me after 6 months. Had genetic testing, and was found to be BRCA2+. Precision medicine determined Olaparib PARP Inhibitor as an effective treatment. Kept my PSA undetectable for over a year.