Parb Inhibitor

[Newyork6264]

I finished 10 rounds of Taxtere in Feb. Unfortunately recent blood tests show my PSA has doubled from 5 to 11 and alk phos from 61 to 125 in last three months. The good news is that the CT scan and bone density scan showed no progression and some improvements. Including fact that "suspicious nodules" in my lungs are gone. Since I'm Brac 2 positive my onc is suggesting a parb inhibitor vs. more chemo. He wants some neuropathy I have in my feet to improve before more chemo. Does anyone on here have experience with Parb inhibitors? I know they are fairly new. I like the idea of not having more chemo (It would be Jevtana) but if that is best way to go so be it. He says of parb inhibitors don't work we can circle back to Jevtana.

[Tall_Allen]

PARP inhibitors work well for BRCA+ but they can have harsh side effects. Carboplatin+taxane chemo tends to work well in people in whom PARP inhibitors work. Makes sense to take a break - 10 rounds is a lot.

[Newyork6264 in reply to Tall_Allen]

What kind of side effects?

[Tall_Allen in reply to Newyork6264]

In a recent trial of one:

• The most common treatment-emergent adverse events were anemia (49%), nausea (33%), decreased appetite (28%) and asthenia (24%).

• Serious/life-threatening adverse events included anemia (31%), decreased platelet count (9%), neutropenia (8%), and pulmonary embolism (6%)

• 12% discontinued treatment due to adverse events

[Newyork6264 in reply to Tall_Allen]

Thanks. As always good info.

[HopingForTheBest1]

Also BRCA2+. Had Olaparib before it was approved, via off-label use. It was effective for me for almost 2 years, keeping my PSA undetectable until it ran its course. which is typical.

[Newyork6264 in reply to HopingForTheBest1]

Did you have any side effects?

[HopingForTheBest1 in reply to Newyork6264]

Anemia, partial blood clot, fatigue

[Newyork6264 in reply to HopingForTheBest1]

Thanks for input

[Hidden]

We tried Olaparib for 3 months. It worked but his QOL was destroyed. Bedridden. Lost 30 lbs. Dementia. Pain levels shot up. Had to stop. But, everyone responds differently. Worth a try. But I wish we’d tried Jevtana first. Side effects are supposed to be much less. We’ll find out when current med fails. It’s our next try if we don’t go for LU-177.

[Newyork6264 in reply to Hidden]

Sorry to hear. Good luck with treatments.

[Scootman]

I hoping for your input I started taxatere in dec 20 my Alkaline phosphatase was at 400 and then stated to drop to 82 in april and yesterday was 89 concerened about in increase. Also psa was 60 when I started and started to drop 1-21 16,9,2-21 13.1, 3-8 15.4, 3-16 had catheter in went to 24.8 and now I am self catherizing daily and went up to 32.11 yesterday. Has bone scan and ct scan on 4-7 and stated uptake was less than previous bone scan and some of the spots on pelvis showed some shrinkage. I am really confused and would appreciate your opinion. Does the daily catheter cause the psa to rise I would think so but what do I know also you mentioned about dying cells shedding psa is this a possibility . Just really confused and concerned because of the trend in the psa even though scans a month ago seemed stable .Finished 6th chemo yesterday I guess I have to wait for next scans to to really know. This ride is is really taking a toll mentally. Also failed to mention I still have my prostate in tact and size is 128 cc. I am my wits end trying to decide whether to continue with the chemo if it id really working or did I have a change for the worse in one month. Sorry to go on so long just so confused and the oncologist I have just does not seem to want to answer any questions just states you have an aggressive cancer,

[Newyork6264]

Thanks. As always very helpful.

[Scootman]

Did genetic testing came back negative. Just told it was aggressive because it was from biopsy gleason 8 ,no one else with cancer I am the lucky one. Spoke with my urologist and she stated that she felt the catheter would definitely affect psa just confused and concerned. They still have me scheduled for more rounds of chemo.

[Scootman]

you mentioned dying cancer cells shedding psa how does that work into the equation?