Chemo or clinical trial?

[rsgdmd]

Am scheduled for bone biopsy of met(s) from my hip tomorrow. Stopped Pluvicto after #3 due to rising PSA and progression. Hoping to get next gen. sequencing from biopsy sample and (maybe) functional testing. But, it's going to take some time to get results and I feel I can't wait. Pain has been getting worse in past couple weeks since had scans and saw my MO. Worst mets are in lower spine & hips, which is where pain is. On 600mg gabapentin TID, but that's not cutting it. Oxycodone is helping, but only minimal.

MO suggested can do cabazataxel or look at AR degrader trial. There are also BITE trials near me, but everything is phase 1. I'm thinking asking to start chemo asap & wait for test results. If chemo seems to help & nothing comes of tests, continue with more rounds. If testing shows something, look to make a switch. Does the idea of using a couple rounds of chemo as a way to carry me thru til next treatment make sense?

Anyone have experience with AR degrader trials? BITES? Thanks.

[Tall_Allen]

It sounds like a good plan to me, since Keytruda didn't work for you. Maybe discuss adding carboplatin to cabazitaxel.

[dhccpa]

What's involved in getting a bone biopsy? What type of doctor does that?

[rsgdmd in reply to dhccpa]

Being done by musculoskeletal radiologist.

[dhccpa in reply to rsgdmd]

Thanks that's a new one on me, but I guess radiology has all sorts of sub-specialties.

Once you have the procedure, any feedback would be helpful. I see bone biopsies mentioned here but few specifics from anyone actually doing it.

[rsgdmd in reply to dhccpa]

I have heard it's not bad - I'll be sedated; not sure to what extent.

[Mgtd in reply to rsgdmd]

I am not sure if there are different types of “bone biopsies” but I just took my wife for one. It was taken from her hip. It was done in the office and sent off. It took about two weeks for results.

[rsgdmd in reply to Mgtd]

Mine is also hip. They are doing x-ray guided to make sure they get cancer cell - trying to get sequencing of the cancer from the met.

[Mgtd in reply to rsgdmd]

It was interesting to watch it being done. Took maybe 10 minutes. Local pain killer and she walked out without pain. Minor pain latter. It is a fairly routine and common procedure for cancer diagnosis.

They sent it to Florida for the analysis.

[Poweredparaglider]

Started in a Phase 1 AR degrader trial January 5. Similar circumstances to you, did 3 courses of Pluvicto and while it stayed in the targeted areas ( checked 2 weeks post treatment with a Geiger counter) my cancer grows faster than Pluvicto was killing it. PSA and Alk Phos continued to rise, and clinically my sacrum pain increased. My MO pulled me out and got me into the trial. Pain increased to the point I had to do some radiation, 12 treatments (palliative of course) to the sacrum. That took my PSA from 3.6 to 4.8 in a couple weeks, expected according to radiation Doc, but also took my Alk Phos from 275 to 180. It's now been 3 weeks since radiation done, PSA 2.7, Alk Phos 109.

Had bone and CT scans last week, so far, everything is stable, but drug development Doc says he'll feel more confidence in another couple months. Can't tell at this point which is drug and which is radiation.

At this point on the drug, zero side effects. Obviously you have to decide for youself, but for me, Taxotere effects lasted 3 months, I will probably not to any more chemo. Even though this is a Phase 1/2, my wife and I decided to go for it.

[rsgdmd in reply to Poweredparaglider]

What is the drug name & dose? I'm looking at CC-94676. There's a trial of ARV-766 near me as well.

[Poweredparaglider in reply to rsgdmd]

BMS 986460. 30 spots in US only for phase 1. They'll add 60 more if it goes to phase 2. Not sure of recruitment status, good luck!