I'm attaching the relevant part of my tumor testing from the biopsy samples. I'm high volume metastatic cancer, currently on Lupron, had to stop abiraterone due to liver numbers off, & had 1st Docetaxel chemo a week ago. Sounds like Keytruda could be beneficial as immunotherapy. Possibly concurrent with docetaxel?
What should I get out of these results? The other biomarkers were negative, TMB and MSI were both high. TIA
Congratulations! MSI-hi tumors often have an almost miraculous response to Keytruda.
That's encouraging. When might something like that be tried? Concurrent with chemo? After? Instead of? Thanks.
It is FDA approved for any MSI-hi/dMMR cancers that "have progressed following prior treatment and who have no satisfactory alternative treatment options." Check with your insurance to get prior authorization,
fda.gov/drugs/resources-inf...
Since I'm just started on chemo, there is no prior treatment. Sounds like something for the future, if needed. Wonder if after chemo, the mutation of the remaining cells will be the same...
MSI-hi doesn't go away. I think ADT might even qualify as a prior therapy. There was a recent pilot trial of earlier use that made news because results were so spectacular. I'd push to get it ASAP.
npr.org/2022/06/07/11035453...
(dostarlimab is the same kind of drug as Keytruda)
BTW- a recent study showed that PARP inhibitors are ineffective with MSI-hi, but if Keytruda works, it shouldn't matter:
True and thanks for your advice in the past. I won't repeat my history but wanted to let you know that my psa is still undetectable as of yesterday. Lupron was stopped in January of this year and keytruda was stopped in March. However, testosterone, hemoglobin, and red blood cell count have not recovered at all. I know it's a little early to take action on those low readings. Thanks again and you are a great asset to this website.
You might have a good shot with Keytruda...I was MSI low but a Hypermutated Tumor Burden 232mut/mb to your 23mut/mb, I was given a 3-6 month terminal diagnosis, it was found I was small cell Neuroendocrine differentiation and nothing conventional was working for me, 55 infusions later, I am still in long term durable Clinical Remission NED 8 yrs later...it's been my wonder Drug..and no treatment for 2 years, but 2 annual maintenance doses per my request only since I have tolerated it so well...Good Luck that you may be an exceptional responder as I am...God Bless.
Ive been here on the forum long enough I shouldnt have to ask this stupid question.Was your genomic testing done via a blood sample or from a tumor?
Keytruda the wonder drug....
Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 07/07/2022 8:28 PM DST
Abiraterone after Docetaxel for mCSPC?
Docetaxel
SEQ SOLID TUMORS COMPREHENSIVE Genomic Analysis 
Docetaxel rechallenge
Are there any foods that might taste slightly good while on Docetaxel and Xtandi?
