After 2 years of Trelstar my husbands PSA is now 2. He had RP in 2011, with PSA 32,followed by IRT. No symptoms at all now, no sideeffects from ADT which took PSA to 0. Small rise in blood pressureHas anybody survived for a lenghty time adding a new ADT drug? Should he have chemo? He is 75 years old, exercising daily. Sorry for all my questions, but this forum hosts so much experience and knowledge!
I should add that scans has been clear.
Best wishes from Sweden
He should have a PET scan to confirm metastatic spread. Lots of choices- Zytiga, Xtandi, docetaxel, Xofigo (if in bones), Pluvicto (if available). And if BRCA+ on a biopsy, a PARP inhibitor. Also, wise to check for MSI-hi/dMMR, even though it's rare.
Thanks TA! So there is a possibility of adding more adt. Could he have some more years out of that? Here in Sweden they do not test genetics, so we cannot hope for precision medicine. What about Lu177?
You may have to go to Germany to get Pluvicto.
you could add abiraterone or related drugs but not more ADT.
No more ADT? Should you not combine treatments now? Or do you mean BAT?What would be most favourable? Sorry, I am so worried, he so much wants to follow our sons a longer time ahead.
I think Grandpa4 misspoke. Your husband will continue ADT (Trelstar) and you will add something to it.
sorry yes . I meant you can’t increase ADT but you add abiraterone to it.
If the scans are clear, he castration-resistant without mets. In this case I would add Darolutamide to Trelstar because this works well, has the lowest side effects and is approved for this situation.
Thanks GP! Have your heard about success of Darolutamide aďded to Trelstar? Or does it only work for a short time?
Here are reports about Darolutamide with ADT (e.g. Trelstar) in non-metastatic CRPC:
urotoday.com/transformative...
urotoday.com/conference-hig...
ncbi.nlm.nih.gov/pmc/articl...
So it seems favorable to now combine Trelstar with Darolutamide. Has anybody experience with this? Can it last a lengthy time, ie years? I read about a member who got 17 years out of Erleada, is this to prefer? Thinking of Magnus, who thankfully is back here, and his long, long time living with PCA. So comforting to know that it is possible for some! Thank you GP24 and all of you out there!
All the best
In the third link I provided the autors mention: "the median time to PSA progression was 33.2 months". So this is close to three years.
🙏 Thanks GP
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