My husband's cancer has grown on Zytiga so we're already on to the next option. His MO has suggested either Jevtana or a Phase 1 trial of the new Fortis drug. It's a Cd46 antibody attached to an undisclosed chemo agent.
It's really just a leap of faith. There doesn't seem to be anything online about how this drug is doing for melanoma trials. No one here has posted about it that I can find.
This is probably our last good chance to stop the cancer. He's getting worse and upping pain meds. I'm afraid they are recommending only what's available within their own health network.
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I would go with the one that's proven: Jevtana. There's lots of trial data you can look at with Jevtana. One of the more recent trials was the CARD trial where Jevtana was compared to switching second-line ADT agents. Jevtana proved much better.
You may or may not have seen these references concerning CD46 in the context of prostate cancer, and also the related Phase I clinical trial. The "safety" trial started a while back, and apparently continues, which usually implies that it was not stopped early "for cause".
Well, in looking at the inclusion/exclusion criteria, it doesn't seem to exclude him for previously taking Jevtana. So he can do 6 cycles of Jevtana, and he can still enter the trial in 15 weeks. It appears to be a one-year trial, so he can sequence it the other way too, a year later.
There are a few antibody-drug conjugates (ADC) in clinical trials, and also antibody-T-cell-enlisters (BiTEs) which is a similar strategy. Here's a couple of Phase 2 ADC trials that had good results:
As tango65 pointed out, Jevtana would exclude him if done first. But I agree with him that you can drop out at any time if the cancer is progressing; indeed, they may insist on it.
I believe he will not be eligible for the trial if he is treated with chemotherapy. Since the cancer failed Zytiga, the cancer is castration resistant. Chemotherapy in mCRPC is not allowed.
"Exclusion Criteria:
Persistent clinically significant toxicities from previous anticancer therapy
Prior treatment with cytotoxic chemotherapy for mCRPC (chemotherapy in the hormone-sensitive setting is allowed if > 6 months before study entry)"
I have been in 4 clinical trials so I will go with this trial. Discuss with the doctor the possible side effects.
One can drop from a trial at any time. The SOC does prolong life but eventually the cancer becomes a monster impossible to control. It is always a gamble but if this works it could control the cancer for a while and if it does not work IMHO there is not much to loose.
For a non-medical standpoint, this Phase 2 trial measures cellular suicide by weaken the cell walk. CD26 is present on the exterior of the cell wall. FOR46 attacks CD46 causing the cell wall to collapse and die. Use of other active agents that cause cellular destruction would interfere with the study.
I do not think that are not going to see multiple systemic treatments today combined with gene therapy because interference.
However, cellular apoptosis or cell suicide is good.
My limited knowledge came from a world class researcher generally known to be ahead of his time. The six month trial which I participated in during 2004 attacked PCa by combining six agents known to cause cellular apoptosis. It was a Phase 2 trial to determine safe yet effective agents previously approved by FDA, but not generally accepted specifically in combination to kill cancer cells. The key words to me were “in combination with”. I note that today, the six agents which I took are common in combination for treating metastatic breast cancer.
As I was told in 2004, “We researchers found out how to kill cancer in 1978. The problem was that the cure was so toxic that it killed the patient first.” And, “I believe that I am there.” speaking about dosage and combinations of agents.” And, “Every way that I sliced and diced the mouse, the cancer is gone.” Coupled with watching my father die (my RN mother believed that my father’s death was brought about sooner through the use of chemotherapy. It is why some in our age group fear chemotherapy.)
There are many similarities between breast cancer and prostate cancer. And, there is a vast a difference in research funding between the two. Why?
I have written about the great success I experienced as a guinea pig and I will forever be grateful for the research of Dr. Robert J. Amato. His work was early and did not cure everyone. Those with greater scope of disease, although helped and further delayed their cancer, was different from those who were treated very early in this metastatic journey of ours.
Some say antidotal, I say it’s a start. A start that let me hear the words, “I can no longer find any cancer in your body.” I write my words to give hope to others who are on the SOC journey that delays mortality onset.
Until the answers are found, keep hope and above all keep killing the little bastards; sooner than later.
You are correct in any current treatment being a shot in the dark. I would suggest trying it, but that said, and more importantly, realize that he is a very sick man, is likely on his last stage of the war on pc so better to spend as much time enjoying and doing what little he can.
I am one of the view, and after seeing far too many die of prostate cancer, that one does not want to be kept alive by being bombarded with drugs and treatments etc. to the extent that there is NO quality of life left, and one becomes a piece of beef on a hook, being used by the medical system to make money off of keeping him alive. If we treated our pets the way that end stage patients become, we would be in jail.
Grime news, but such is the reality of having advanced prostate cancer and most other cancers, as pain and suffering are not really signs of any kind of life style that one should have or want to have. Enjoy what time he has left.
TO often men are NOT getting the straight goods and thus begins this game of trying to be beat Father Time and do anything but face the music.
I can advise, as a have earlier stated that men with prostate cancer, are the WORST when it comes to not wanting to know the state of their disease-and this refusal to face the music, results in huge costs to our medical system and staff, the family and of course US.
One would never build a house without plans, rebuild an engine without expertise and a manual, but in the case of apc, too many are NOT getting up to speed on their disease and work with what is known, i.e. stage, current health, age, fitness etc. instead spend huge amount of time, money and energy by attempting to build an engine that is shot. In other words, men should read and get themselves up to speed and create a life plan, both for the treatment of their disease, and in direct connection to this also plan the balance of their lives given the FACTS.
My best friend, god rest his soul, did not listen, did not get himself up to speed in terms of treatment and died a terrible and very painful death, on his second last day, told me that he wished he had listened. He still would have died, but would have had two or three more years of life!!!!
First of all.... if you knew me better you would understand that I was merely breaking your chops about sugarcoating and etc.
I know exactly where you're coming from. Most men do not want to know about doctors, hospitals, medicines and etc. Most of them leave all of that to their spouses. Men do not like reading instructions/directions, case in point "left over parts when assembling their children's tricyles/toys".
You're absolutly correct that men do not like to face the music. Perfect example: when a man visits a doctor and the doctor says "everythings okay" they can't find the exit door fast enough. When a doctor tells a woman "everythings okay" the woman asks the doctor "what do you mean by okay?"
Well it's noble of you to try to wake us up and to take on more responsibilty and knowledge regarding our malady.
That's right, had your friend, God rest his soul, listened to you may have lived another two or three years. The saying goes 'you may lead a horse to water.....'
Please keep posting here and reminding us that we are the masters of our own fate.
thanks pal, no offence taken. I have been at this a long time and as my life winds down, I still see the same scene repeating itself. I also worked with several researchers and they too, had the same complaint about men and getting them to get involved in their care. We also found that it was the wives of our men who did the most and took control-which is ok too, but still, we have one life, and we should cherish it and ensure that we do our part in our own care.
That said, with us advanced guys, we have to really make the effort to get informed and to reorganize our lives to live the best as we can with the time left, however long it is.
I've read all of the current replies and lets face it, I'm not nearly as knowledgeable as TA, Whimpy and others.
However, I just sent this email to my MO (considered one of top ten Docs in NYC).
I'm sending the email in its entirety (those who know me on the forum might get a chuckle. Right Scott and Brother K?)
So here goes:
Hey Doc,
Hope all is well. All set for our phone consult on 9/14.
Met with Dr.S (my RO) 2 weeks ago and did a DRE ( I thought that was all behind me! Pun intended 😁). He mentioned that he could barely feel my prostate (is that good?).
However, my reason for this email is to help another APC brother on the forum.
Could you provide your take ( you will remain anonymous, if that is your wish).
This man's wife is overwhelmed with concern and desperation.
Best,
AJ
FOR46 Trial - How the heck to decide?
CantChoose
CantChoose•
24 hours ago•10 Replies
My husband's cancer has grown on Zytiga so we're already on to the next option. His MO has suggested either Jevtana or a Phase 1 trial of the new Fortis drug. It's a Cd46 antibody attached to an undisclosed chemo agent.
It's really just a leap of faith. There doesn't seem to be anything online about how this drug is doing for melanoma trials. No one here has posted about it that I can find.
This is probably our last good chance to stop the cancer. He's getting worse and upping pain meds. I'm afraid they are recommending only what's available within their own health network.
The facts are that it is unlikely that any given trial will make much difference on the remaining life of a current end stage prostate cancer patient. What these trials do, is to allow progress to be made in terms of making prostate cancer a chronic disease, where one can have an extended life by monthly/yearly or whatever treatments.
it is important to know that most cutting edge treatments may add a month or a few more months to a life, so there is no magic bullet yet, so one should NOT expect to have this happen.
I always recommend to get on at least one drug trial if you can, I have been on two, because while we may die, we might save our children or other family member or friend by our sacrifice.
Sadly, at this time, the medical community does not work together, do NOT share their findings so that they work building on each other's works. THIS IS CRIMINAL IN MY VIEW, as we, who will die of this disease, have no say on how government and other funding is being done. This is happening because of the money to be made for the firm that creates a treatment that will make pc a chronic disease.
Right, wrong or otherwise, a tremendous amount of money being poured into research is redundant and being wasted, perhaps up to 70% of funds end up in the trash can
You can see the same thing happening with our current virus research, and again, a failure by governments to force researchers to ALL work together, is hampering finding a treatment.
Note that no government platform says that they will force this cooperation to happen so greed and ego are allowing many men to be killed before their time!!!
My husband was in the same boat. Zytiga did nothing for him at all. The cancer spread quickly after he stopped talking docetaxel. he was He did amazingly well on cabazitaxel (Jentana). I Unfortunately it was short lived. I pray that your husband responds to his next treatment for a very long time.
Your journey of hell started around the same time as mine. Wife to wife my heart hurts for you. I pray that some treatment will work and that you two will have yrs❤️
Im the least knowledgeable person on here. However, Jevtana combined with Carboplatin was very effective for me, and that followed with Xtandi/Lupron has kept my cancer at bay for almost 4 years, zero psa dormant lesions.
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