Stay in trial or find a new one?

[hadleycash]

Started a clinical trial with Lynparza and AZD6738 ATR inhibitor on 3/15/2021. (My profile shows detailed history from diagnosis in 2014.) On start date my PSA was 17.77. It reached a nadir of 6.92 by 5/24/2021. In two weeks, on 6/9/2021, it had gone to 11.32! This past Tuesday, two weeks later, it rise to 31.71!!! Comparison of bone scan imaging now to two months ago has improved with some mets fading, no new ones, and comment in "Impression" of mildly lower uptake of radiotracer overall "suggests favorable treatment response". Note to those who don't review my profile details, I have a historical DT of just under one month while off meds or when they fail. My new DT is two weeks! LDH on 5/7/2021 was 193 and now is 303. Alk Phos has remained right at 80 over the same two month period. Why are the bone scans better and Alk Phos stable, but PSA is rising off the charts over the last month? Bone pain, always fairly mild, is better too. My onc at UVA recommends continuing therapy in the trial as he says "Despite the rise in PSA, your imaging and clinical symptoms have improved. The treatment does still appear to be working and helping." I have read a number of times in HU about PSA rising from cancer killoff... but not sure I've had enough killoff to account for this. Any thoughts to explain the bizarre results I'm looking at? I am looking at possibly going to a different trial approach... possibly CART cell therapy, PD-1, TGF-beta, etc.. Any commentary or suggestions are gratefully appreciated! For nearly seven years I have never ceased to be amazed at the wealth of support and knowledge offered up in this amazing forum! It has helped me greatly to navigate the way on this journey. Many thanks to the entire HU Team and regular posters... especially Tall Allen and Nal for the wealth of help given!!!

[Tall_Allen]

It is a mistake to think that your PSA is the cancer. It is only a biomarker. Remember, your cancer may be more vulnerable when it is active and producing more PSA. Some treatments extend life (e.g. Xofigo and Provenge) without reducing PSA.

[hadleycash in reply to Tall_Allen]

So you would look past the rising psa as long as my symptoms are the same or better and until imaging says differently?

[Spyder54 in reply to hadleycash]

HadleyCash, every ounce of my common sense says stay the course. Less pain is key! Better Scans=“Every Picture tells a story, don’t it”. I have heard from some of the brightest minds on HU, we are fighting Cancer, not PSA. You’re making progress Brother.Mike

St Pete

[hadleycash in reply to Spyder54]

Thank you for you thoughts!

[hadleycash in reply to Spyder54]

Thank you Spydy!