Xofigo 2.0

[Tall_Allen]

It's been almost 8 years since the FDA approved Xofigo for symptomatic, bone metastatic, castration-resistant PC, with no visceral metastases. I thought it useful to provide an update on what we've learned since then, and where Xofigo-related therapies are headed.

prostatecancer.news/2021/02...

[Dban]

Thanks T-A. Great gathering of info into one place. Appreciated.

[MarkBC]

Thank you Tall_Allen. I really appreciate how you share all of this information. There is no way I could learn it all on my own.

[cesces]

Thanks for the article.

"It is FDA-approved for castration-resistant men with painful bone metastases, who do not show evidence of visceral metastases on a CT or MRI"

Do you know if it is a large portion or a small portion of metastatic patients who have bone metastasis without any visceral metastases?

[Tall_Allen in reply to cesces]

Large, at first.

[cesces]

Do I read you correctly when I read that:

men taking Xtandi and a bone-strengthening agent have 4x (13%) the bone fractures than do men taking Xofigo and Xtandi with a bone-strengthening agent (3%).

[Tall_Allen in reply to cesces]

I didn't get that wrong.

[pleinairpainter]

Thank you again T-A! Your research and write-ups are greatly appreciated. For many of us, we would have no knowledge of this information.

[cesces]

"PARP inhibitors (e.g., olaparib, rucaparib, etc.) have known activity in men who have certain DNA-repair defects, particularly BRCA mutations (either germline or somatic)."

Is there any evidence or reason to believe that PARP inhibitors work well with tp53 DNA-repair mutations?

[Tall_Allen in reply to cesces]

There is evidence that they do not.

[cesces]

Oh.... One more time, what an impressive and thorough article.

You really should start publishing your articles in peer reviewed journals, if there are any that are well suited for what you write.

I am certain there are medical practioners who would benefit from your analysis and synthesis of breaking research.

[Ahk1]

Thanks a lot, TA for all your efforts always.

[tallguy2]

This is an outstanding compilation of the latest research. Thank you so much for posting this.

[strummer]

My husband's scans have been stable since diagnosis 11/18. (No new mets ) His first treatment was Docetaxel and Firmagon. Still gets Firmagon monthly and Zometa ev 3 mos. He completed Provenge 5/20 and immediately began Xofigo, ending 10/20. Followed by a scan that showed less uptake.

Now his scan from 1/21 shows a new spot for first time, on a rib. He is doing radiation for 3 wks.

Any thought as to why a new spot appears 3 mos after Xofigo? It is not only concerning but confusing. Thanks

[Tall_Allen in reply to strummer]

Why is he doing 3 weeks of radiation? Why not just a single zap?prostatecancer.news/2019/08...

Did they biopsy the new metastasis?

[strummer in reply to Tall_Allen]

No biopsy. He doesn’t have any pain but hoping to shrink or get rid of it. Doing 3 wks vs Sbrt because spot is high on rib and trying to minimize radiation on lung. I’m surprised that it showed up so soon after Xofigo. Didn’t expect that. Thanks

[Tall_Allen in reply to strummer]

Good reason for slow radiation! They may want to biopsy it first. If Xofigo didn't touch it, it may be particularly radioresistant - histology and IHC may change the treatment.

[strummer in reply to Tall_Allen]

Thanks, I will ask about that.

[Bluebird11]

Thank you, this helped us greatly. Your contributions give meaning to the lives of others. When we get clarity, it isn't just us, it affects our family and all we interact with....

💖

[meemsie]

Do you know if Xofigo impacts PSA? Xtandi failed after a few months. He has had 2 Xofigo injections so far (Jan. and Feb 2021). However PSA was 7.16 in Dec 2020 and 18.24 in March 2021. Still on Lupron and Xgeva.

[Tall_Allen in reply to meemsie]

It usually does not reduce PSA. It is more effective at reducing micrometastases, so you should not use PSA and your existing metastases as your guide.

[meemsie in reply to Tall_Allen]

Thank you