I have not been on any treatment since I stopped Docetaxel chemo last year except Prostap injections every 12 weeks. My PSA went up from ~9 to 20 from May to September. I have just been invited to take part in a phase 1a safety and tolerability study of NX-1607. It aims to inhibit CBL-B (Casitas B-lineage lymphoma proto-oncogene) which is a gene responsible for proteins important in the regulation of the immune system. Inhibiting CBL-B is expected to increase immune cell response helping it fight cancer. Is anyone aware of this trial and have any idea of side effect likelihood been identified? Does anyone know of any successful trials so far?
Merry Christmas All,
Richard
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konichiwa12
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I’m not in Japan, I just worked there a lot. I’m in Newcastle England. I have been advised to try any clinical trials before having 2nd stage Cabazitaxel chemo.
£40,000!! It may be a LOT less expensive to get it in India. I agree that you may not require as many infusions because of your low burden. In fact, too many infusions may be increasingly toxic.
This pilot study found that " All 10 patients showed altered PSA kinetics postponed androgen deprivation therapy, and maintained good quality of life. Half of the patients showed a PSA response of more than 50%. One patient had a complete response on PSMA-PET imaging until EOS and two others had only minimal residual disease."
I get antsy over immunotherapy trials because of the long history of failure of such trials for PCa. Maybe some of the BiTE or CAR-T trials will be different.
you can have Lu 177 in Italy as well (Actinium in Austria), to confirm that you are eligible they would first require your docs (ok if they are in English) then a visit (costs about 40 euros) then they can say yes or no.
Thanks for the info but my Onco is adamant that Lutitium 177 is not worth doing for me yet. He specifically gave me an example of another patient who had it but it didn't work due to low burden. 🤷♂️
I've had the foundation liquid biopsy test twice and the results were negative both times. They believe there is not sufficient circulation dead tumor cells to show up.
Consider the possibility that your Onco may be wrong about that. Lu17 may work even better in earlier low-volume disease and especially if lymph node only. Better to consult with a doctor who works with it all the time. Such as Ishita Sen in Dehli, or Nat Lenzo in Australia (GenesisCare AU). I had Lu177-J591 from Dr. Lenzo 18 months ago (particularly good for low-volume residual disease after SBRT). It cost about $11,000 US for the two dose treatment total. PSA went down 90% initially then gradually became undetectable.
Unfortunate. So SBRT would not be beneficial except for managing painful sites. Lu177-PSMA could be a good choice especially if no non-concordant sites on FDG PET. But I would look into Ra223 (Xofigo) especially with Provenge. The trial may be a wild card but may exclude getting better established treatments.
J591 has little to no salivary side effects. I had none. But the reason I chose it over Pluvicto was better efficacy in eliminating residual prostate cancer. Yes at nearly two years it has worked very well. PSA undetectable
I've had 3 PSMA screens before. I have had Abiraterone until it stopped working. The only established treatment left is the Cabazitaxel. As the burden is low he feels it is an opportunity to participate in any trial. Lu177 is an option but it's not a NICE standard. I had private health care until I took early retirement in January so would have got it here for free! It's confusing to me as I thought the PSA was the main biomarker but the trials professor at the Freeman in Newcastle said "for example, the lymph node met has increased from 12mm to 15mm which is not dramatic". I will start this trial after a Carribean cruise end of January. The trial is a dose escalation trial so I'm pretty sure placebos aren't involved?
There are some parallels between yours and my PCa stories except I'm high burden mCRPC. I'm in the middle of 10 cycles of docetaxel and as you say, the only remaining treatment on offer by the NHS after that is Cabazitaxel. However, it's not the only established treatment available - just the only one the NHS offer. I will be looking seriously at Pluvicto but as you point out, it's very expensive. Like you, I lost my private health insurance when I retired last year. I had genetic testing when first diagnosed which didn't show any mutations but things may have changed so I'm considering getting a liquid biopsy done but again, I'm told the NHS won't fund that so I'll have to self-pay. It may indicate a specific treatment such as Parp inhibitors or immunotherapy could be effective. Failing all that, I'll be looking for a suitable clinical trial.
Can I suggest you also try taking a natural remedy to boost your immune system as Chemo drains your bodies ability to fight Cancer, Buy “Black Fermented Garlic” in Capsules they are 12 times stronger than normal garlic & can fight & can prevent 14 types of Cancer on their own, do some research using google
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