Treatment update-continuing on Jevtana/Carbo combo

[HopingForTheBest1]

After having treatment #7, my PSA went up to 42 from 18 after #6 three weeks prior. Treatment #8 was put off. Subsequent CT and Whole Body Bone Scans indicate no progression of disease from those 2 1/2 months prior. My MO has reminded me that we can't just rely on PSA alone, which could indicate cancer cells are dying off.

I have had multiple past treatments with no long term success, except for Olaparib PARP as I am BRCA2+. It kept my PSA undetectable for almost 2 years, my longest lasting and effective to date. I have found that re-challenging Olaparib, or using any other PARP, is not a viable option at this point.

After much discussion and research, I decided to continue on with the chemo combo. I am simply running out of next treatment options, my scans are indicating stability, and I have been experiencing tolerable/limited side effects. So, I had treatment #8 yesterday (8/6/22).

I will continue researching my Plan B. Pluvicto is my main next step contender. Also, having discussions with NY Presbyterian, Weill Cornell and Johns Hopkins about clinical trials being conducted. Trials usually require a washout period from prior treatments before starting.

Hoping for the best.🙏

[dico]

Thanks for the update. Hope your doc is correct and the PSA increase is a one-off. I appreciate your posts and look forward to next month when you tell us that your PSA is back down again.

[Tall_Allen]

I think Pluvicto is a good choice. I think that both PSMA PET and FDG PET will give you a pretty good indication of how well it will work.

[CAMPSOUPS]

You really have both feet planted in the survivor club here. Been thru a lot.I do hope its cell die off affecting PSA.

Nonetheless Pluvitco it seems comes highly recommended these days and the PSMA/FDG scan can be informative by itself in guiding treatment Pluvicto or other tx.

You have often found your way thru this mess and give us a lens into possibilities. I am sure you will have more treatments available if even trials in the future.

Your MO's come from highly regarded institutions to boot so you have that as well.

Keep us posted. Wishing/hoping the best for you.

[HopingForTheBest1 in reply to CAMPSOUPS]

Thanks so much from your kind and insightful words. It means a lot. We are all in this together.

[Seasid in reply to HopingForTheBest1]

They won't take you to the clinical trial with Lutetium PSMA therapy if you are on ADT longer than 3 years. I believe that the cancer slowly converts from PSMA positive to PSMA negative. The PSMA positive cancer would be killed, but the PSMA negative cancer would repopulate and kill you. Xtandi would fail also at some point of time in the future after 3 years of ADT and would develop new mutations.

[CAMPSOUPS]

👍 Indeed we are yep.

[robert570]

I am getting round 5 (of 6) of Jevtana this Monday, August 8, 2022. My PSA started out at 2.76 before round 1 and now it sits at 3.59, slow rise during treatment. They have me on 10 mg of prednisone along with Abiraterone. I'm getting concerned that it's not working, but I have 2 rounds left yet. My bloodwork has all come back normal. I had my prostate removed back in May of 2014. Abiraterone and Prednisone worked up until this past December. PSA started to rise from 0.18 to 0.92. Dr. put me on Xtandi, did not work. PSA kept rising, he started the Jevtana and put me back on Abiraterone and Prednisone. I have bone Mets, so I've been receiving Xgeva too. I get Lupron Depot twice a year. This is where I'm at now.

[HopingForTheBest1 in reply to robert570]

I see that you just joined this group. I recommend you post details about all your past treatments in your bio.

You should be having periodic scans, usually CT and whole body bone scans, to more definìtively indicate your disease progression other than PSA changes alone.

If you have not had genetic testing, talk to your MO about getting it done asap. It could determine future effective treatment options.

I am also on quarterly Xgeva and Eligard shots.

I was previously on Abiterone/Prednisone, but it only lasted me 6 months.

[Aodh]

I’m glad that you are able to continue with treatment. Your strength shines through your posts and is very encouraging to me at least. Wishing you the very best.

I’ll continue to keep you in my thoughts.

Hugh

[bellyhappy]

Thank you for sharing. I wish you the very best. Praying for your success