Has anyone else been down this treatment to add Talzenna to their adt treatments? I started only a few days ago. Side effects seem to be severe. Kidney pain, back pain, brain fog, fatigue. I stopped after only day three. Awaiting my MO to respond to the call for help. I feel way too medicated. Coming off of some beam radiation to hit hotspots after a pluvicto 6 rounds, which did not last very long after treatment before I was started on the extandi. My blood counts were low from the radiation so a shot to increase wbc counts before starting the talzenna. I have a PALB2 mutation (was told is very close to the BRCA mutation). I feel like this is a very strong and powerful drug. Long term use seems to be very difficult for me to perceive after only a couple of days feeling like a truck ran me over. Everyone is different as we all can see by hanging around this forum. I was also told that a immunotherapy could work on me due to certain mutations that are good targets.
I was hyped up for months about this parp inhibitor being a great next treatment but if I cannot get out the gate, what’s the point. Hoping to hear others that may have tried or are on this treatment plan.
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Apd66
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I d-not know what that means, but it sounds like I should. We were so focused on the parp. Dr did call me today and trying a lower dosage of the talzenna. If still too toxic then abandon parp for keytruda. What can I ask to know my indication for immunotherapy.
Thanks! High tumor mutational burden (TMB) might indicate a response to Keytruda. Maybe you can get both Provenge and Keytruda.
"the mutational burden in metastatic prostate cancer is generally low (median, 2.9 mutations/megabyte), and only 3.0% to 8.3% of advanced prostate cancer tumors have high TMB [note:yours is 61.4 mutations/megabyte - very high!]. In a small retrospective series of 12 patients with high TMB (defined as more than 10 mutations/megabyte), four (57%) of seven patients treated with an anti–PD-1 antibody had a PSA decline greater than 50%. Treatment with ipilimumab [Yervoy] and nivolumab [Opdivo (similar to Keytruda)] resulted in an ORR [objective response rate] of 56.3% in patients with a TMB above the median (74.5 mutations/ patient) in the CheckMate 650 trial as well as longer radiographic progression-free survival when compared with those who had a TMB below the median (7.4 months vs. 2.4 months). It is plausible that high TMB may be a genomic manifestation of dMMR. However, given the limited data demonstrating the association between TMB and response to CPIs in randomized clinical trials, TMB is not considered a biomarker of response validated for clinical use."
Thank you for that information. A pretty dry read and a lot to decipher . Is there a precursor to The Provenge strategy? You mention both, is that a combination? Your reply has me started on the research for the provenge therapies and if I am a candidate. Some others on this forum maybe have gone this route. I’ll search that as well. If my particulars are aligned for pronenge, it sounds much more inviting than 2 years of ketruda infusions, that still could be on the table if provenge fails? You are a wealth of information and your advocacy is really appreciated.
Do not get discouraged, there's a lot of info and help on this site. Also Do Not rush into decisions.... investigate first........(haste makes waste)...
One suggestion, Ask your MO to send biopsy sample to Keytruda and Keytruda team will tell dr immediate whether Keytruda going to work for you or not. Thank you.
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