Slowly rising PSA - Your Thoughts Wanted

[davebliz]

I'm CPRC with multiple mets to bones, BRCA2. I'm now on the Magnitude study (Zytiga, Pred and either Niraparab or placebo). Been on for 7 months. My PSA was 11.6 when I started Zytiga. It dropped to 3.5 but over the past 7 months, it has slowly increased (4.0, 6.0, 6.1, 7.9, 9.5, 12.1). I'm getting CT and Bone scans every two months and the doctor is saying that all the mets are stable and he isn't concerned about my slowly rising PSA. Overall I like being on this clinical trial but the rising PSA does have me worried. I appreciate your thoughts and experiences. Thanks.

[GP24]

The reason for the rise in PSA is either that Niraparab does not work for you or you are in the control group. Zytiga seems to become less effective now. I do not want to recommend to drop out, the rising PSA value alone will not kill you and they need patients in the trial. You may have more success with Olaparib though.

[kaptank]

Radiographic evidence beats PSA. But to be really sure, you need a PSMA scan. I am on MAGNITUDE too, but the arm that everyone gets niraparib. My PSA has been slowly declining over 5 months. Scans show stability.

[HopingForTheBest1]

Also BRCA2+. Was on Olaparib for 2 years, most of which PSA was undetectable, before it ran its course. Definitely an effective treatment for me.

[MateoBeach]

Is there criteria for crossing over from placebo to active drug built into the trial protocols?

[davebliz in reply to MateoBeach]

I don't think there is any crossover planned.

[Hidden]

Also biallelic Brac2, responds well to Ola,Brac2 upregulated PSMA to 300, luPSMA should work nicely after I will be Ola resistant. There will be trials for POL Theta inhibitor late 21, blocks the backup pathway for those who are Brac2 deficient.

[Pchoo]

Yours taking a different path than mine .

3 months after robotic surgery PSA shot up ; pre ~16 to post 33 .

Lucrin brought PSA from 15~16 to 1.0+ in 4 months but rising back to old level 16 .

Had PSMA scan prep for RT starting 10 months after surgery 7weeks:5x/week .

PSA from 15~16 to 1.0+ in 6 months but rising back to old level 16 also leveling .

First in my group to start Zytica and Niraparib* simultaneously .

Fortunately it works well so far as PSA dropped 16 to 0.02 over 18 months .

* *

Heavy rectum&anus bleeding started 13 months post RT .

3 times colonscopy & Stopped Niraparib* after 18 months {placebo?!?}

PSA todate maintained at 0.02 for 10 months ( 26 months on Zytica )

Bone&CT scans maintaining ; no noticable change .

[davebliz in reply to Pchoo]

Hi Pchoo, are you on the Magnitude clinical trial also? If so, are you on the arm that you may get Niraparib or a placebo? thanks.

[Pchoo]

Hi Davebliz, I am the caretaker. Apparently my husband had the placebo arm. After his very bad rectal bleeding they took him out from taking the niraparib/placebo tablet. He is now on only three tablets of Zytiga and 10mg of Prednisone daily. For more than 9 months now, he doesn't have the bad rectal bleeding that he experienced last year. However, on days when his stool is hard, he still has some fresh bleeding from the anus