Anyone on Lymparza with positive results?

[Pops78]

Have bone mets but been on Nubequa since 01/22 and have more mets now at Sacrum and tail bone. Orch last year with good PSA since. Either 3D or IMRT to start soon x 10 days for 3D, (not sure time for IMRT). RO says mets there on scans of 2/22 but small, now larger. We didn't know. MO wants to start Olaparib (Lymparza) 30 days after finishing radiation, but to stay on Nubequa with it. Foundation report on liquid biopsy says good results with Olaparib, Zytiga, and Prednisone in a Phase 3 trial. This is the wife and he is 80 now. Appreciate any comments.

[Tall_Allen]

Good luck with the trial!

[Pops78 in reply to Tall_Allen]

He's not in a trial? Am I missing something your saying TA?

[Pops78 in reply to Pops78]

Would you mind sending me a message to explain? I'm the wife, 78 years old, and trying my best to understand this disease by myself. He can't help. So if I ask dumb questions, it's because I'm trying to help him. But, I've had questions about his treatment. And I appreciate you people more than you know. Thanks

[Tall_Allen in reply to Pops78]

How will he get Lynparza outside of a trial if he does not have a BRCA or ATM mutation?

[Pops78 in reply to Tall_Allen]

He has the mutation CDK12 per Foundation Medicine liquid biopsy.

[Tall_Allen in reply to Pops78]

Will insurance pay for Lynparza for CDK12? I think there are some better clinical trials for CDK12. See links in my reply on this thread:

healthunlocked.com/advanced...

[tango65]

Did they study if the cancer has mutations making it susceptible to treatment with Olaparib?

[Pops78 in reply to tango65]

Yes, a mutation CDK12

[tango65 in reply to Pops78]

This article may be of interest to you:

cancertherapyadvisor.com/ho...

[Pops78 in reply to tango65]

Thanks tango65, everything I read explains more, even though it's scary as heck.

[tango65 in reply to Pops78]

I wish you the best of luck with your treatments.

[Hidden]

Have biallelic BRCA2 - using Olaparib for 18 months bringing PSA down to 0.1. Almost no side effects, swallowing the pills with yoghurt.

Radiation induces SSB, single strand breaks in the DNA threads. Olaparib which is a PARP inhibitor prevents the cancer cells repairing SSB. This leads to double strand breaks. If you have the BRCA2 loss of functionality the cancer cells can not repair DSB and the cells die.

Thus it makes sense to start Olaparib just before radiation.

[Pops78 in reply to Hidden]

Thank you. His MO wants radiation first, then start Olaparib 30 days later? His psa the first of Sept. was still down, <0.1. He has had an Orch. Did you take it with Zytiga and Prednsione or any other drug? Thanks

[Hidden in reply to Pops78]

No, monotheraphy Olaparib. Please give my reasoning to the MO, I am pretty sure it’s correct.

[Pops78 in reply to Hidden]

I will ask her about that, if I can reach her?

[Cooolone in reply to Hidden]

Is there literature supporting this? Sounds interesting... Would love to be able to read and share with my MO as well.

Thanks

[Hidden in reply to Cooolone]

The most relevant documentation: aacrjournals.org/mct/articl...

[Cooolone in reply to Hidden]

Appreciate the link, thank you. But I will say that exhibits results vs Pancreatic Cell structure, not PCa. And my MO and O have gone down this road before, and I do agree somewhat, that it's apples/oranges when comparing different cancers (cells). What works for one does not often translate to others, Interesting otherwise we would all be using the same drugs regardless of the the cancer, which we know doesn't work so well.... I may forward to him regardless.

Thanks again

[nuc1111]

I have BRAC2 and Lynparza reduced PSA from 20 to 2 in 3 months.

[Pops78 in reply to nuc1111]

His PSA at last check, 9/02/22, was still at <0.1

[meowlicious99 in reply to Pops78]

As I understand it There is no PSA rise but there progression in scans. And that's the reason MO is suggesting to add olaprib post RT?

[Hidden]

I just want to say monitor your husband closely on Lynparza. After 5 months my guy ended up in the hospital. Stopped eating and drinking. Dementia like behavior. Organs began failing. Took months to get him back up and about again.

[Pops78 in reply to Hidden]

Thank you! I do have concerns about this med and is it even right for his mutation? Is he ok now? Did all those symptoms leave? Thank you for responding and wishing you both all the best.

[Hidden in reply to Pops78]

he has the BRCA2 mutation. He recovered but it took at least six months to get him back on his feet. I wish I’d pulled him off sooner. We went to Jevtana after that. He’s finished that and did OK on it. But his PSA is rising again. We’re still hoping it’ll stabilize. But we’re preparing for LU 177 if it doesn’t. Of course, the problem is that it’s not that available in the US yet. Even though the FDA approved it in a limited number of cases. He’s in that number but it doesn’t help if you can’t get it.

[Pops78 in reply to Hidden]

My husbands mutation is CDK12 and Lynparza does not work on it as well as on BRAC2. Do you mind me asking how old your guy is? Mine is 80 so all treatments are scary. Not sure where you live but Duke U is using Pluvicto, which I think is LU177? Also MD Anderson in Houston is but says it's hard to get the meds. used for it. Glad you found a med he's tolerating. I guess with all meds, there will be some who have more trouble than others tolerating it but cannot imagine how scared you both were. So glad he's back on his feet. Our MO says he will need to have monthly labs while on Lynparza.

[Hidden in reply to Pops78]

My guy is 68. Diagnosed 6 years ago. Stage 4 with extensive bone nets. PSA over 1,500. We’re in Atlanta. From what I’ve been told only one hospital about an hour from us has LU 177 right now in N. GA. I’ll do more research soon if PSA doesn’t level out from Jevtana

[Pops78 in reply to Hidden]

Best of luck in finding what you need.

[NotAlwaysSunshine]

My husband had a good 8 month run with Lynparza. Little or no side effects, thankfully.