What genetics tests are need to done

[Nirman]

Anybody can tell me what are all genetic tests which can helpful for different medicine like I already have done MSI, BRCA1,BRCA2 if any other tests can give more info or open doors to other treatment right now castration resistant Gleason 4+4 8 abiraterone plus have made steroid switch so dexamethesone is going on

[Spyder54]

Good morning Nirman. ATM. I am neg for BRCCA 1/2, but positive for ATM. Xtandi failed me first 2 mos.. Zytiga w Prednisone not much better regarding Testosterone being controlled. I am only 6 mos since Dx. Also Gl 4+4=8. First 2 mos on Firmagon PSA went from 47.2 down to 8.1 to 4.6. Then added Xtandi. 3rd-4th mo PSA flattened to 4.2,4.1 (also T rose both mos). Switched to Zytiga+Prednisone month 5&6. PSA went up to 4.7 (but T dropped) then 3.8 (but now T rising to 26). Neither one keeping T in check, then PSA follows about 14-21 days behind. I may switch Prednisone for Deximethosone, which appears like you already have.

[Tall_Allen]

Why are you only focused on genetic tests? You've already done that. What did histology and IHC show?

[Nirman in reply to Tall_Allen]

I don’t know about histology or IHC dr just prescribed these three tests brca1 brca2 and MSI and all of them came negative so he said we don’t have any immunotherapy left

[Tall_Allen in reply to Nirman]

There are medicines other than immunotherapy. Discuss histology and IHC with your oncologist.

[Nirman in reply to Tall_Allen]

Hello Allen we already using abiraterone with dexamethesone after steroid switch for chemo or Lu177 treatment right now not possible in India due to COVID situation now we have one option remaining is enzaleutamide I don’t how long it may work as cross resistance so if keyrtuda or any immunotherapy like oral drug he can take at home is the best option for my dad in current situation

[Nirman in reply to Tall_Allen]

Right now it’s really scary Situation here in India like if you go out from your house and you can catch corona infection.

[Nirman in reply to Tall_Allen]

I asked about provenge but he laughed it off saying that provenge is 10 years old therapy and it doesn’t work

[Tall_Allen in reply to Nirman]

I, and many others, disagree. The lack of biomarkers is troubling to some, but the bottom line is that men who use Provenge live longer.

[TheTopBanana in reply to Tall_Allen]

Provenge when one is castrate resistent?

[Tall_Allen in reply to TheTopBanana]

yes- only approved in the US for mCRPC. I don't think it is approved in Europe.

[Nirman in reply to Tall_Allen]

Here in India they have cold response to provenge but there is one company in India which makes personalised vaccine ncbi.nlm.nih.gov/pmc/articl...