Jevtana/Carbo combo after 6 cycles with PSA trending up

[HopingForTheBest1]

Have had 6 cycles of this combo so far. 3 week cycles. Side effects tolerable. Tomorrow will be #7? After initial treatment PSA dropped from 62 to 4. But, the ongoing trend has been an increase to 18 as of yesterday's most recent blood work, from 9 three weeks earlier and 6 three weeks before that. Also meeting with my MO tomorrow before next treatment to discuss if this regimen should continue as it may no longer be effective???

[Tall_Allen]

In your profile, you wrote, "Also have MSS, low tumor burden, TMPRSS2 and PTEN loss." I've never heard of MSS - is that correct?

Ipatasertib recently tested well in men with PTEN loss.

thelancet.com/journals/lanc...

Maybe your MO can contact Roche about compassionate use while we await FDA approval. There is also a similar drug, Capivasertib, manufactured by Astra-Zenica that is also not approved. There is a drug called Piqray that is approved for triple-negative breast cancer, that may work similarly.

Now that you've been through chemo, you may want to try rechallenging with Xtandi, perhaps combined with a different PARP inhibitor, as was proven recently in the MAGNITUDE trial. It may be easier to get rucaparib (Rubraca) because it is already approved for prostate cancer.

prostatecancer.news/2022/06...

[HopingForTheBest1 in reply to Tall_Allen]

MSS is micro satellite stable, as opposed to MSI micro satellite instable.

Being BRCA2+ I had been previously treated with Olaparib successfully, keeping PSA undetectable for almost 2 years before it ran its course.

I will definitely discuss your input tomorrow with my MO. Thanks.