Brip1 mutation

[Voula4ny]

My 82 y/o father has metastatic prostate cancer. He received external beam radiation and ADT therapy followed by zytiga and xtandi. Found to have a Brip1 mutation and started on the PARP lynparza but it didn’t have much effect on the PSA. He received. The initial dose of taxotere And it completely wiped him out. 2 months later and he still can’t walk independently. Any recommendations for less toxic therapy that’s also effective?

[tango65]

Lu 177 PSMA treatment it is a systemic treatment which has shown a survival advantage in highly pretreated patients, This therapy may not have major side effects unless there is diffuse infiltration of the bone marrow by multiple bone metastases. A PSMA PET/CT which has to be done before treatment will indicate if there is diffuse bone marrow infiltration.

There are clinical trials for Lu 177 PSMA in the USA:

clinicaltrials.gov/ct2/resu...

Lu 177 PSMA is available in many places in Europe and in India.

If he has bone metastases he could be treated also with Xofigo.

Cabazitaxel could have less side effects than docetaxel. Chemo could also be done with lower doses and more sessions.

[Voula4ny in reply to tango65]

Thanks! I will see if he’s a candidate

[tango65 in reply to Voula4ny]

Best of luck!!

[Tall_Allen]

Where are his metastases and where is he located?

[Voula4ny in reply to Tall_Allen]

He has Mets to a few ribs and the lumbar spine area

[Voula4ny in reply to Voula4ny]

He is located upstate NY (Binghamton)

[Tall_Allen in reply to Voula4ny]

I think his best bet is Xofigo.

[Voula4ny in reply to Tall_Allen]

Thanks. I’m being told that since he is still severely weakened from the initial dose of taxotere (just completed antibiotics for pneumonia and still can’t walk independently), he is not a candidate for additional treatments.

[meowlicious99]

Whoa that’s a lot of meds. Would mind sharing the timeline and the dignosis.

[Voula4ny in reply to meowlicious99]

Metastatic castration resistant prostate cancer. He is not on any meds now. The taxotere wiped him out.

[slpdvmmd]

Xifigo is available in this country but from my talks with oncologists in Australia they have found 177-lutetium psma to be more tolerated than Taxanes in older individuals and in select cased now use this as first line therapy. So this could be consideration for your father if travel is and option. Realty is that it will be decades for approach to be available in the US unfortunately. For me 6 cycles of taxotere was the hardest thing in this whole personal trial and the thing that the residuals effect from (neuropathy in my feet) bother me more than anything else on a daily and nightly basis. So I understand the struggle with taxanes.

[j-o-h-n in reply to slpdvmmd]

To slpdvmmd,

I too suffered from neuropathy in my feet and was prescribed 1 Duloxetine (Cymbalta) Hcl Dr Caps 30mg once a day and it worked like a charm.

Duloxetine is used to treat depression and anxiety. In addition, duloxetine is used to help relieve nerve pain (peripheral neuropathy) in people with diabetes or ongoing pain due to medical conditions such as arthritis, chronic back pain, or fibromyalgia (a condition that causes widespread pain).Duloxetine may improve your mood, sleep, appetite, and energy level, and decrease nervousness. It can also decrease pain due to certain medical conditions. Duloxetine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). This medication works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

Ask your medical doctor(s).

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 10/23/2021 7:17 PM DST

[Voula4ny]

Thanks. Hoping to try the xofigo but I understand there is toxicity associated with that also.

[j-o-h-n]

Yiasou Voula,

When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!! And "mea giga"

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 10/17/2021 7:46 PM DST

[Voula4ny in reply to j-o-h-n]

Yia sou John,My father was diagnosed was prostate cancer Gleason score 8 November 2017. He was started on eligard injections and completed external beam radiation therapy, followed by zytiga and xtandi. His PSA levels were rising And he was found to have a Brip 1 mutation. We started olapanib (lynparza) but his PSA levels continued to rise. Given an initial dose of taxotere (docetaxel) on 8/17 which completely wiped him out. He was severely weakened and still can’t walk independently. He’s in the hospital and just completed treatment for a pneumonia.The recent bone scan showed worsening metastatic disease : bilateral clavicles, left shoulder, sternum, ribs, left pelvis and in areas of the spine. I’m being told that there are no further treatment options since he is in such a weakened state and we should consider hospice. 😢 That maybe so but want to be sure before we completely give up. Would appreciate any recommendations.

Thanks,

Voula

[j-o-h-n in reply to Voula4ny]

Hello Voula,

Ev-cha-ri-sto for the quick and detailed response. My regards to your Dad and to you too.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 10/23/2021 6:58 PM DST

[kcareer]

Hello Voula4ny, I took 6 rounds of Taxotere chemo January of 2017. It was not a nice experience. It caused me to have so much fatigue. Then I was placed on Lupron, Zytiga & prednisone. The doctor stopped my Zytiga & prednisone, and now I am on Xtandi 120mg every day. My problem now is the peripheral neuropathy. It is so bad that I cannot sleep at nights. I have burning pains in my legs every night. I have now been placed on 1800mg of gabapentine. This helps some times. This is my situation. The Xtandi helps because it has brought down my PSA to a point of being negligible. I hope this helps.

[Voula4ny in reply to kcareer]

It’s helpful to know others have had issues with taxotere -thanks!