Re-biopsy from bone metastatis lessions ? Will it pass proper DNA quality check for BRCA/HRR testing ??

[pka21]

We had our recent PSMA PET SCAN on 19th Mar, Dr. suggested to do re biospy this time to find out any treatable mutation since in last scan we did not get any feasible site. (Majority of standard care got failed/used)

Since nothing is in Prostate, my MO said its generally difficult to do biospy from bone lessions as per our scan and sometime we did not get proper DNA quality for testing, But for checking feasibility, Reffered to IR Dr. Who said they can do it.

But Nobody is giving any confidence that we will be benefitted from this and also my father is little scared of re biospy.

Can someone pls share their experience or thoughts on this?

[Tall_Allen]

Even if there is no tailored therapy yet, there may be some in clinical trials.

[pka21 in reply to Tall_Allen]

Thanks TA for the response!

MO planned to start Honovan and Nuclear Med Dr. gaved the option for Ac225 as further lu177 is not going to be benefitted.

For Ac225 also, waiting period is more than a month for med availability and it is costly as well.

Also Not sure how it will work after lu177 got failed , considering patient has many psma avid and many psma non avid sites present on psma pet scan.

Can Ac225 work in our case ?

Regarding clinical trail, As per Dr, there is no clinical trail going on in TMH and not sure about other places in India. Request ur help if you have any info on this please.

[Tall_Allen in reply to pka21]

I think PSMA-targeted radiotherapy is dangerous in men with discordant cancers. Some disagree.

prostatecancer.news/2019/12...

[MateoBeach in reply to pka21]

What does Ishita Sen say?

[ishitasen in reply to pka21]

We have treated a number of patients with Ac225 following failure with lu177. There is usually a fairly good response with a median duration of progression free survival in bone only disease of about 8 - 9 months. The problem with Ac225 is the salivary gland toxicity and the cost. Also to some extent the availability. The Ac225 supply chain will likely improve after about 6 months, till then supply is extremely restricted