Questions for those currently on or have tried Olaparib or Rucaparib PARP inhibitors. Recently published study on Rucaparib.

[mrssnappy]

For those of you who have tried or are on PARP inhibitors, which one did you use and at what point did you use them? Was it before chemo or after chemo? Did insurance cover the cost?

Looking at the NCCN guidelines, which my husband's MO refers to often, they suggest Olaparib (Lynparrza) before chemo and Rucaparib (Rubraca) after chemo. They also list two other newer drugs. I'm looking at page 53 in these guidelines - nccn.org/patients/guideline...

Zytiga is starting to fail my husband so he will be getting another PSMA scan in a few weeks and looking at what's next. He does have a somatic BRCA2 genetic defect.

I went down a rabbit hole on this topic after reading this news article about a study on Rucaparib's metabolite M324 and the possible use in Parkinson's. My husband also has Parkinson's.

From the article, Specifically, the synergy demonstrated between Rucaparib and M324 in prostate cancer cell lines could have an impact on clinical trials for advanced stages of this type of cancer. On the other hand, the fact that M324 is capable of reducing the abnormal accumulation of α-synuclein in neurons derived from stem cells of a Parkinson's patient highlights the therapeutic potential of this metabolite and its possible pharmacological application for the treatment of this neurodegenerative disease. - msn.com/en-us/health/other/...

The folks who contributed to this study have a commercial interest in a range of drug targets, including PARPs. Maybe they are being overly optimistic of the possibilities, but I do find it interesting.

[mrscruffy]

I am BRCA2 and went 7+ years on Zytiga/Lupron. Added Lynparza to the mix in November. It is working great or as my MO said "maybe too good" as it has affected red and white cells and will eventually harm my bone marrow, so I have been taken off for 2 weeks to re-evaluate my dosage. Lynparza is still quite pricey with insurance and my wife and I have great pensions so we don't qualify for low income help. Contacted Astra Zeneca direct and they have provided me with 14 months of Lynparza at no cost to me. Fun fact: My MO was part of the Lynparza development team. Any further questions let me know . I have never had chemo

[mrssnappy in reply to mrscruffy]

Thank you for that response mrscruffy. That's good to hear Lynparza was working for you and that you were able try it before chemo. Hopefully that can adjust it so you can stay on it. Nice of the drug maker to help out. When you say it's still quite pricey with insurance, is that with Part D copays or something else?

[mrscruffy in reply to mrssnappy]

With my Advantage plan. Their estimate which was hard to pin down was 4K a month. Never got that far.

[Har036]

My husband has an ATM mutation and had been on Lynparza for the past forty months until two weeks ago when his neutrophil count dropped to below the acceptable range.

He is getting labs today. He was on the lowest dose so I don’t know if he’ll restart it.

My husband started the Lynparza after Abiraterone and prednisone failed (only four months). Prior to that he tried Provenge, He also completed xofigo. He of course is still getting an ADT. We are in a place of prayer right now hoping his labs get better so he will be a candidate for chemo. We’ll know more after we get results and talk to the doctor.

Praying that it goes well for your husband too.

The first year our insurance paid for the lynparza but since we have received it free directly from Astra Zeneca.

[MoonRocket in reply to Har036]

That is a tremendous response to lynparza.

[MoonRocket in reply to Har036]

Do you happen to know the exact ATM mutation your husband has? It should be noted on his genetic test report.

[MyDad76 in reply to Har036]

What was your husband’s dose (Lynparza)?

[mrssnappy in reply to Har036]

Praying your husband will be able to move forward with another treatment. Thank you for sharing.

[Har036]

200mg/twice a day. He started with 400mg twice a day.

[MyDad76 in reply to Har036]

Thank you. Regarding your husband's low neutrophil count - I'm not an expert but what about Neulasta injections? I know my mom had low level of white blood cells after chemo and was than given Neulasta after every chemo session.

[Har036 in reply to MyDad76]

He’s had Neupogen before. Waiting on lab results to see what’s next. Thank you!

[j-o-h-n]

Would you be kind enough to tell us, how old is Rick? (And if you wish add it to his bio)...

Good Luck, Good Health and Good Humor.

j-o-h-n

[dadsdrdawn]

I wish I could help. My dad never did chemo.

I'll simply send prayers that you/he makes informed decisions, with the least amount of side effects, and that you are all optimistic.

Sending love,

Dawn

[Har036]

I wanted to update everyone regarding my husband. After several weeks off the Lynparza my husband’s neutrophil count began to go up from 800 to 1300 without the help of medication. Unfortunately his calcium level began to rise while being off the lynparza. This could be an indication that bone metastasis could be active so he was restarted on the lynparza and will be closely monitored for blood counts and calcium. He received his bone shot so it should help lower calcium too.

[Bamagrad]

Thank you for the update. So glad to hear lynparza is effective. Who did you contact to get lynparza for free?

[mrssnappy in reply to Bamagrad]

Bamagrad, here's a link to the patient support for Lynparza. lynparza.com/patient-suppor... My husband didn't qualify for any financial support being on Medicare with United Health Care supplement. The first month was just under $3000.00 copay and 2nd month was free. All his other prescriptions will be 0 for the rest of the year. We have Wellcare Part D for prescriptions and that plan is 0 each month, no premium.