Latest Update on PATCH

[cam123]

For those of us using tE2 as a primary therapy to control advanced prostate cancer, there is new information in Clinical Oncology, Vol 36, Issue 1 „“ A repurposing Programme Evaluating Transdermal Oestradial Patches for the Treatment of Prostate Cancer within the PATCH and STAMPEDE Trials“. It‘s a long read but very informative on trial design, history and progress to date.

My initial reading is that the news is all good with confirmation of efficacy, improved SE profile regarding Bone Mass, reduced hot flashes, and absence of any increased cardiovascular problems vs SOC LHRH, and reported improved QOL. The study population (n) has been split into a comparison of those with metastases vs localized for better analysis of the advanced prostate cancer group. If I remember correctly the population includes those using tE2 in addition to advanced therapies ( aberraterone, xtandi, taxanes, etc.)

Interesting to note that some of the big Pharmaceuticals are involved in the funding in addition to College of London and UK.

[GP24]

This is a link to the article: sciencedirect.com/science/a...

[dhccpa in reply to GP24]

Thanks. I'll show this to my MO.

[JohnInTheMiddle]

Thanks for sharing Cam. Just a heads up for people who are interested in the Patch trial and Estradiol (aka "E2"). The Patch trial is about substituting high-dose Estradiol as ADT, replacing either agonist or antagonist GnRH drugs (Leuprolide, Degarelix etc.) for that part of any PCa therapy program.

The other use of Estradiol in the context of prostate cancer is different. That is low-dose transdermal Estradiol as "add-back" estrogen therapy. This second possible use of Estradiol is also very exciting, against what one might say are the unnecessary and even life-threatening side-effects of ADT-driven estrogen suppression.

But alternative use of Estradiol is not the topic here today. Sometimes there is confusion between the two uses of Estradiol.

[dhccpa in reply to JohnInTheMiddle]

Thanks. Excellent info.

[JohnInTheMiddle in reply to JohnInTheMiddle]

In case anyone is interested, here are some posts on the question of Estradiol as add-back Estrogen against PCa therapy side-effects (you might want to scroll up and down the thread):

healthunlocked.com/advanced...

healthunlocked.com/advanced...

healthunlocked.com/advanced...

[VHRguy in reply to JohnInTheMiddle]

IMHO, the overlap of these cases is in the risk assessment of the high-dose estrogen therapy vs low dose backfill. If the high dose T-stopping goal has acceptable risk, then the low-dose backfill strategy should be acceptable too.

All too often I hear from fellow patients that their urologists refuse to prescribe even low-dose estradiol (active part of estrogen, and what's in these patches). They won't prescribe cross-sex hormones, partly because it's that, and partly because they have old outdated concerns about vascular issues. So they'd rather the men suffer and even give up on hormone therapy because they feel so awful. It's sad.

I'm on a full replacement level of estradiol, and I feel absolutely terrific. My PSA has now been undetectable for almost 5 years.

[EdBar]

I’ve been using the patches for nearly 9 years now, along with Lupron, Xtandi and Avodart, all originally prescribed by Snuffy Myers. The patches were initially prescribed for SE’s, although he did have me on a multiple patch high dose regimen for a while to aid in healing areas of bone damaged by PCa. Perhaps his multidimensional form of treatment (something he always preached) has truly had an impact, I’m coming up on 10 years since dx with G9, Stage 4. All I know is I haven’t changed any of his original protocol and don’t plan to either. I also still take 2000mg of metformin daily per Snuffy.

Ed

[VHRguy in reply to EdBar]

I've pointed others to Dr. Myers's recommendations for this as well. It breaks my heart to hear of guys really suffering from their ADT without relief for some really miserable symptoms. Few urologists have ever been on ADT, and it seems they have no empathy for us.

[janebob99]

I'm a big supporter of Transdermal Estrogen patch therapy and plan to use it myself. I spoke with the lead researcher, Ruth Langley, and she said that the final results of the PATCH phase-III trial will be published this Fall.