When is PARP introduced?

[positive-thinking]

Hi

My husband is currently on triple therapy ( Docetaxel chemo , Zoladex every 3 months and nubeqa) he has one more chemo round left next week. He is responding well so far as PSA is declining ( see profile for PSA) . I have seen some men are talking a PARP inhibitor and nubeqa and zoladex ( or ADT equivalent med's). Have been told by some we stay the course we are on till Castrate resistant than due to BRCA2 we would than try the PARP. My questions are 1: Is the nubeqa stopped and the PARP added to the Zoladex or does he still take the nubeqa , zoladex and PARP? # 2: Is the PARP the best thing to try next when nubeqa no longer works or should he try something else first? ( if so what) ? Thanks for any info

[Maxone73]

hi! It is added but refer to a study called BRCAAWAY, olaparib + abiraterone if I remember correctly

[Tall_Allen]

PARP inhibitor is an option when you are castration-resistant. The latest info is that they work best when combined with advanced hormone therapy.

prostatecancer.news/2022/06...

When you become castration-resistant, there are several options, and there may be more by that time.

[positive-thinking in reply to Tall_Allen]

Thank you for the information , after reading this news article you attached it sounds like he will be off nubeqa and will be trying a PARP with Zytiga or Xtandi. (when he becomes castrate resistant) After all the reading about the side effects of all of these I will be praying he can handle them and they work .

[God_Loves_Me]

Your husband is responding pretty well to Docetaxel, and you are also asking the right questions. Tall_Allen has already responded to you.

I am not a doctor, so talk to your doctor and take advice. I think PARP is one of the toxicants, so it is important to understand its side effects. My biggest challenge was understanding the side effects and navigating the treatment plan.

[positive-thinking in reply to God_Loves_Me]

Thanks for your reply and hope you are doing well through this nasty disease that has a grip on so many . The more I read about PARP the scarier it seems. It seems very toxic and I could not agree more. The side effects are a huge part of this as they can do more damage than good , problem is no one knows what side effects they will get and have to at least try. We never thought in our 50's we would be talking about them and we know what it does to the body. We are crossing our fingers and toes and hopeful for no side effects and take a deep breath with each blood work up in hopes it will continue to work. I search for the next step and go between moments of dread and hope. God bless you , have the best day

[Hidden in reply to positive-thinking]

I have taken Olaparib for 18 months due to biallelic BRCA2, keeping PSA well below 1. Hardly any SE, so d’ont worry., PARP only works of you have BRCA2, approx 8 % has this mutation. PARPi also works together with BAT, 50%.

[j-o-h-n]

"dread and hope" Thought for the day....... thanks.......

Good Luck, Good Health and Good Humor.

j-o-h-n

[5_plus_4]

I had chemo for bladder cancer using platinum based drugs. It was horrible. But, everyone reacts differently. I didn’t get the drugs you mentioned.

Looking back I would have refused chemotherapy, and the immunotherapy I received after my recurrence made me feel awful too.

Good luck and God bless you