Seeking Advice on Clinical Trials or Treatments for Advanced Prostate Cancer with Bone Marrow Involvement

[Fightingformyfather]

Dear Forum Members,

I am reaching out for guidance and support regarding my father’s ongoing battle with advanced prostate cancer. About a year ago, he was diagnosed with stage 4 prostate cancer with extensive bone metastases but no organ involvement. Recently, we discovered that he has a BRCA2 mutation, which we believe may have accelerated the progression of his cancer.

My father has undergone all standard treatments available and has been in the metastatic castration-resistant prostate cancer (MCRPC) phase for approximately six months. We initially planned to proceed with Pluvicto; however, his uptake values were not sufficient. As an alternative, his doctors recommended cabazitaxel due to his previous positive response to docetaxel during the hormone-sensitive phase.

Unfortunately, shortly before starting cabazitaxel, he was hospitalized due to thrombocytopenia. A bone marrow biopsy revealed that the cancer has extensively invaded his bone marrow, significantly affecting his red blood cell and platelet counts. This discovery has placed him out of contention for both Pluvicto and cabazitaxel.

Despite extensive research and advocacy on my part, I am struggling to find information on potential clinical trials or alternative treatments for his condition, particularly given the bone marrow involvement and low blood counts. Palliative care has informed us that he may have only weeks or months to live.

Given the current situation—his hemoglobin level is stable at 8.5, he is mentally sharp, his pain is managed (though it has been a challenging journey), and he feels relatively well—I am seeking any advice or recommendations on potential clinical trials or treatments that might still be viable.

Thank you for your time and support. Any insights or suggestions would be deeply appreciated.

Warm regards,

Nicholas

[NickJoy]

Hi Nicholas, you mentioned that your Dad has had all of the standard treatments but I just wanted to check whether he has had Olaparib?

[God_Loves_Me]

I am sorry to hear about his situations. I know it is not easy.

Do you have access to ARX517 or AMG 509 Clinical trials ?

[Tall_Allen]

Due to his low hemoglobin and bone marrow involvement, a PARP inhibitor wouldn't be advised.

Has he had Xofigo and Provenge yet?

[Rolphs]

Some patients have had success with Dr. Onik (garyonikmd.com/). He's been doing a personalized immunotherapy cancer treatment for several years and claims an approximately 30% success rate. I have not used him but spoke with him on phone and he is a very devoted practitioner. I intend to reconnect with him when I become castrate resistant. IMO you could at least find out if your fathers a good candidate.

Good Luck!

[j-o-h-n]

Greetings Nicholas, We all understand your anxiety regarding your dear Dad's issues. You've come to the right place for help and information regarding his Pca. It may be helpful if you would update his bio with his age, location, Medical team and Medical center. You're a great son and deserve your father's and God's blessings. Keep fighting his fight....

Good Luck, Good Health and Good Humor.

j-o-h-n

[dulcimerdude]

The Fred Hutchinson Cancer Center at University of Washington has a new trial, VALOR TRIAL. It involves taking an oral medication, Vorinostat to augment Pluvicto for patients with low PSMA uptake. I can't say if your father meets all eligibility requirements but it's worth checking. I will be starting the trial this month.