What comes next?

[rsgdmd]

So, de novo, high volume metastatic, diagnosed in April, 2022. Initial PSA 28.2. Started on triplet - Lupron, Abi & docetaxel. Due to liver issues, had to stop abi right before chemo. Restarted abi about 6 weeks after last chemo. at 500 mg, moved to 750 & then 1000, but had to go back to 750 due to high bilirubin. PSA hit low of 0.48 in mid-Jan. and has been rising since. Tried switching to dexamethasone (from prednisone) but didn't help.

I have scans & see my MO this week. I expect my PSA will be 2.0 or close to it. I'm a good candidate for Keytruda, as I have high TMB, high MSI. My WBC took 5 mo. to finally get to normal range (low end) after last chemo, despite Neulasta, so concerned about more chemo or Pluvicto, which can both cause myelosuppression. So, I assume will be switched to enzalutemide & taper off steroid before starting Keytruda. Wondering if anyone has failed abi & had enzalutemide (or daralutemide) work for them? Thanks

[Tall_Allen]

Good luck with the keytruda!

[j-o-h-n]

Keytruda worked for my Lung Melanoma metastases.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/07/2023 12:09 PM PST

[rsgdmd in reply to j-o-h-n]

Thanks. Any side effects?

[j-o-h-n in reply to rsgdmd]

None...

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/08/2023 10:01PM PST