ADT + Abirterone Failing what's Next?

[Back2future]

Dxd in 3/2021 w/ stage 4 PCa (no RP or radiation). After only 5 months on ADT + Abiraterone my stage 4 PCa decided to turbocharge into stage 5. My PSA scores have trippled in past 2 weeks from .6 to 2.00. Now its time to pull out the big guns. I know what most of you will say Chemo. Yes, but you know that increases PSA for 4- 8 weeks. What if I take chemo with Xtandi instead of Abiraterone and Orgovyx? Any thoughts? What has worked before when the PCa is out of control?

[Hidden]

what does your MO suggest? Not sure why you wouldn't go with your MO's recommendation unless you do not trust your MO.

[Back2future in reply to Hidden]

I have 2 MOs one is at John Hopkins and other at private practice. I will talk to both this week.

[lcfcpolo]

Hi mate. Hopefully TA and the others can advise on Enzalutamide with Chemo and your other questions. I would also consider having genetics tests to see if BRCA or other DNA mutation. It could open up new treatment options. I keep looking at LU-177 and or AC225 treatments, a bit behind you, particularly if can get on a trial. Good luck. Graham

[Back2future in reply to lcfcpolo]

Read my mind. It would have to be chemo or LU-177 trials for me since we know WBC and RBC collapse after chemo and render me ineligible for LU-177 trial if I do chemo first. As for AC225 they are accepting if you live in one of the nearby states. Otherwise you have to go in person. Let me know if you get in one of those trials.

[Woodstock82]

>> "...Chemo. Yes, but you know that increases PSA for 4- 8 weeks."

Not my experience at all, with either docetaxel or cabazitaxel.

[Carp1707]

Have you had any genetic testing done, either on you or the tumor, germline or somatic?

I was tested and found my tumor has a mutation that Keytruda is very effective in dealing with.

As soon as it quits working that's the treatment my MO is going to put me on.

I've been going to Fred Hutchinson, UWMC (U Washington, Seattle), and now at Seattle Cancer Care Alliance. All parts of the same organization.

Even though my Dad passed from PCa; I had no mutations in germline but the tumor itself has mutations.