Anyone with ATM gene mutation?

[Maxone73]

Trying to understand if I got a good or bad news...

[MoonRocket]

Yeah...ATM here...how was it found? Germline, Tissue Biopsies or Liquid Biopsy?

[Maxone73 in reply to MoonRocket]

Germline (venous blood)

[MoonRocket in reply to Maxone73]

If you have kids, make sure they get a germline test too... anyway, you'll mostly be interested in the ATR Inhibitor trials and PARP Inhibitor as a possibility, Lynparza the primary one.

I think the platinum based chemo work better.

It's not as bad as brca1/2.

[Maxone73 in reply to MoonRocket]

my MO presented me only the good part, like "it does not influence time to castration resistance and in case we have an extra weapon (PARPi)", but I did not like it...no kids, but a brother and two sisters (and a 95 years old mother that is a force of nature who does not need to know!!)

[MoonRocket in reply to Maxone73]

I think I have license to say this, my wife is 100% Italian. Lovely people that evolve into complete lunatics as they grow older.

[Maxone73 in reply to MoonRocket]

I am a lunatic now!!

[MoonRocket in reply to Maxone73]

If I'm any sort of guide, Im 4.5 years into this and still HSPCA, was on mono Eligard and now adding xtandi per the EMBARK trial. Get to < 0.1 and come off treatment. Repeat after PSA rises to 1.5.

[Maxone73 in reply to MoonRocket]

I am metastatic, so they put me on triplet straight away...adt + daro + docetaxel

[Maxone73 in reply to MoonRocket]

Hopefully it will take a while before I get CR, but I like to know my options and I have read that ATR inhibitors may work better than current PARPi...

[Tall_Allen]

It is bad in that it is one of several possible homologous recombination repair genes (HRR), which means that mistakes in your DNA are not corrected. This increases your propensity to get any kind of cancer. However, unlike BRCA mutations, it does not respond well to PARP inhibitors. Olaparib is FDA-approved for it in the US, although it is ineffective for it. There are no specific medicines for it, although men with it respond to hormone therapy and taxane chemotherapy.

There are a couple of early clinical trials targeting it:

clinicaltrials.gov/study/NC...

clinicaltrials.gov/study/NC...

[NOTaQUITTER in reply to Tall_Allen]

Thanks TA. Very interesting. Are you aware of any research being done with early-stage PCa patients (I am an Active Surveillance Gleason 6 member of the club). I have the ATM gene mutation, otherwise completely healthy at age 54 (diagnosed at age 51). I would raise my hand to participate in such trials if they are being planned/considered...

[Tall_Allen in reply to NOTaQUITTER]

Those are the only ones I know of.

[Maxone73 in reply to Tall_Allen]

Thank you Allen! I hope those trials will get some positive results. Bad bad day today.

[Amadeus71 in reply to Tall_Allen]

Yes, thank you TA. I have ATM gene mutation and was told it is common and not to worry about it.

[Tall_Allen in reply to Amadeus71]

Well, it's not all that common. It occurs in 1% of men with localized PCa, and 1.6% of men with metastatic PCa. But I agree that since there is nothing you can do about it with today's medical technology, there is no point worrying about it.

[Maxone73 in reply to Amadeus71]

Correct lifestyle, exercise...but I suppose you are already doing that if you are here! And maybe get your closest blood relatives to do the same, and if they are males precocious PSA tests and pap test mammography for females I would suggest.

[aesteve]

i have it. dx'd at 49. 5.5+ years on abi/pred/lupron and radiation to two mets. recently radiated prostate and dropped the abi/pred.

[PCaWarrior]

urotoday.com/video-lectures...

"We also, of note, saw high rates of responses in those with ATM mutations, CDK12 mutations, and other genes that didn't necessarily show high response rates in some of the other studies testing rucaparib, olaparib, and some of the other prostate cancer PARP inhibitors that are being developed."

clinicaltrials.gov/study/NC...

[Maxone73 in reply to PCaWarrior]

I noticed, but I have found also something elese very interesting (not PCa related but ATM related):

actionforat.org/crispr/ but I need to discover more

[Maxone73 in reply to PCaWarrior]

link.springer.com/article/1...

it's a field where I have some secondo degree connection with a couple of biotech startups. By the end of the year some CRISPR treatments were supposed to get FDA approved and start commercialization...