Does anyone have the age of participants in the peace trial.
When I ask the MO’s about triple therapy for my dad who is 83 and has bone mets and when I mention the trial , they say oh the trial had younger men and maybe maximum in their 70s and prescribe doublet therapy for dad.
We already established that your MO is an ageist. Neither PEACE1 nor ARASENS had a maximum age. PEACE1 patients may have had any ECOG PS 0-2. ARASENS allowed ECOG PS 0-1. I have more detailed demographics for ARASENS, in which 17% were 75+ years of age. There is no reason why age alone should preclude him from getting the best therapy.
Thanks Allen. 😊
What does this mean ?
“PEACE1 patients may have had any ECOG PS 0-2. ARASENS allowed ECOG PS 0-1.”
Allen , if chemo has to be given , Can it be given lower dose or something like that and when is the right time to start it ? Dad is taking orgovyx since a week now and the plan is to start with 40 mg xtandi after a week
What is the standard chronology when triple therapy is given
I've already told you that performance status dictates whether docetaxel should be used.
Why are you screwing around with dose and sequencing that we know are effective? You do not know better than the doctors who conducted the trials.
Why I asked about chronology was because the MO’s here say let’s do the doublet therapy and see the results with that and depending on that we can maybe think of chemo later or not and that for now it is overkill they say - but I have read your posts say the cells go into senescence or something like that.
Hence I asked when triple therapy is given , what is the usual sequence -so I can be more proactive and try to impress upon the MO’s the triple therapy .
I've told you several times, but you don't seem to get it. Triplet therapy means all at once, not sequentially. Sequentially doesn't work - understand?
yes I get that but all 3 are started on same date or some gaps of weeks between each
Your MO can read the methodology for himself.
How soon after starting adt and second gen adt does the senescence set in , ?
Follow directions to the letter.
Allen , I see most trials seem to compare adding the second gen ADT like abireterone to adt plus chemo.
Can you please point me to the trial which compares first and second gen ADT vs first and second gen ADT PLUS chemo
I get tired of repeatedly answering the same questions from you.
If I remember correctly the timeframe to add chemo to adt and second gen ARSi is 8 weeks. Where his MO is wrong it that of course there are 99% chances that there will be a positive reaction to doublet therapy, but not as deep and durable as with triplet therapy. So waiting to see if there are positive results and in case add chemo makes no sense.
Do you know which trial compared first and second generation adt to first and second gen adt plus chemo ?
I don’t believe there is such a comparison. The best place to read the leading physicians discuss trials issues and standard of care is at UroToday, in my opinion
i did triplet therapy. I was at the tail end of 68 when I started.
I started on Lupron and casodex to control the initial testosterone flair. Then the casodex was stopped.
Shortly thereafter I started six Taxotere treatments given in three week increments. During those treatments I continued on Lupron.
Post Taxotere treatments I was placed Abiraterone Acetate 1000mil per day combined with 5mil of prednisone twice daily.
Background info...
Urologist discovered my prostate cancer.
PSA 13.1. Biopsy done. 4 of 12 cores cancerous. Bone scan done. No bone mets. RP surgery done. PSA < 0.1.
Post RP surgery within months I had a chemical resurgence. Post RP I went from PSA scores < 0.1 to 0.13 to 0.25.
Up to this point I was still in the care of my urologist.
He ordered a bone scan again which showesd no bone mets. He subsquently ordered PSMA PET SCAN.
PSMA PET SCAN revealed lower lymph node involvement.
At this point I was handed off to oncology.
Oncology updated diagnosis to Prostate Cancer, Ductal Variant Stage IV. Gleason score 8.
Oncology gave me three options.
1. Lupron alone. Two year life expectancy.
2. Lupron and Zytiga 3 to 4 years
3. Lupron, Taxotere, Lupron/Zytiga 6+.
I was advised that hitting it hard right out of the gate was the best route to go. I'd feel like shit for 6 months and my hair would fall out; but the results were more promising...
I elected option 3.
I entered Oncological treatment with a PSA number of 0.29. One Lupron shot and two Taxotere treatments later I was again back to a PSA number of < 0.1.
All subsequent treatments have held my PSA at < 0.1 (undetectable) 4 tests so far.
i completed my Taxotere treatments on Feb 14th 2024. I started pill treatment end of March... and am continuing Lupron shots, quarterly.
Regarding Taxotere... For me it was a breeze... I would have what I called chemo dips... A few days after treatment I would experience a few days of tiredness that did not resolve with rest. Then I would bounce back. My hair did fall out. I did not experience the plethora of potential side effects they caution about.
My take on chemo is it's like ROUNDUP for the body! It circulates killing those little bastards wherever they are hiding!
The trick is to be stronger than the treatment...
My hair is coming back, albeit I look like a chia pet...but hey... I could be dead by now, so...
My oncologist did indicate without an actual explanation that I had about a month from starting Lupron to decide about the chemo... though he said it could be instituted later on with potentially less effect...
best wishes
RON
check ARASENS
I saw that. That compares adding darolutamide to adt and chemo VS not adding darolutamide.
What was mean or median age of the PEACE prostate cancer triple drug therapy trial cohort
ChatGPT
The PEACE trial you're referring to is likely PEACE-1, a significant clinical trial investigating the efficacy of a triple-drug therapy for metastatic castration-resistant prostate cancer. This trial examined the addition of abiraterone acetate and prednisone to androgen deprivation therapy (ADT) and docetaxel.
In clinical trial publications, the demographic data such as the mean or median age of the participants is typically reported in the results section. According to the publication of the PEACE-1 trial results, the median age of the participants was reported as follows:
Median age: 68 years
For more precise details, including age distribution or any subgroup analyses, consulting the full text of the trial's published results in a medical journal like The Lancet or a similar peer-reviewed source would provide comprehensive information.
there is a lower benefit on average for older men because more discontinue due to side effects:
“Conclusions: This post-hoc analysis of PEACE-1 suggests that, in the overall population, OM derive a lower benefit, both in terms of rPFS and OS, from adding AAP to SOC versus YM. This decreased benefit is likely due to more toxicity leading to more frequent and earlier drug discontinuation. Importantly, in OM fit enough to receive ADT+D, the benefit of adding AAP to SOC was comparable to YM.”
Thanks. But this compares adding AAP to ADT plus chemo - not adding chemo to ADT and AAP
Most of the renowned doctors here in India go for doublet therapy only . For some quacks i met , during my search were insisting of chemo only for getting quick bucks .
Finding a good and honest Oncologist in India is a tough task .
I am 81 and started doublet therapy 6 months ago. I know triplet is better, but at the time, I did not know how well I could tolerate doublet, and I was afraid that adding docetaxel chemo would be too much at my age.
Perhaps I will come to regret not doing triplet, but I have passed the short window for adding docetaxel. Chemo kills actively growing cancer cells, and does not kill them when they become senescent from hormone therapy. I think the window is around a month.
The doublet of Orgovyx and Abiraterone did not affect my quality of life at all, so I would be willing to add docetaxel but it is too late.
thank you. I pray the doublet will work for you for long 🙏🏻😊
Where did you read about the window being one month ?
I see most studies seem to compare adding second generation ADT to first generation adt and chemo but I don’t know which study compares first and second gen adt vs first and second gen adt plus chemo - do you know ?
You diagnosed with bone mets ?
A scan last December found no bone mets, just nodes.
At the moment, I can't find a specific window for adding chemo. TA just says around the same time. "You can't do chemo after Zytiga helps. You have to start them at around the same time (called "triplet therapy"). The reason is that cancer cells that are not killed by Zytiga go into an impervious state called senescence. Chemo only kills rapidly duplicating cells. -Tall Allen in Healthunlocked: healthunlocked.com/advanced...
This article says early chemo is important: prostatecancer.news/2017/06...
As for comparing doublet to triplet.: "... trials have demonstrated a survival benefit of upfront triplet therapy with ADT, docetaxel plus either abiraterone acetate or darolutamide when compared to ADT plus docetaxel alone." ncbi.nlm.nih.gov/pmc/articl...
On the studies, just read the introduction or abstract, and then the conclusion. I started Zytiga (mine is called the generic Abiraterone) on March 3.
Clinical Trial In Canada or USA?
Trial in Troy Michigan,
End of Immunotherapy trial - what next?
Management of the Metastases in Oligometastatic Prostate Cancer 
End of trial
