Clinical Trial or Standard Treatment?

[brokenyoyo]

I had been taking 3, 40 mg Xtandi daily and Lupron shots every 3 months until new cancer growth was seen in lungs and 4 bone locations in late 2023. After 9 rounds of docetaxel in 2024 which kept the lung and bone Mets at bay, my MO suggested I try Pluvicto. After two recent rounds, it appears there is limited PSMA uptake and new disease growth, so we stopped Pluvicto. My MO likes clinical trials and wants me to do this next: "A Study of JNJ-78278343 in Combination With Either JNJ-63723283 (Cetrelimab), Taxane Chemotherapy, or Androgen Receptor Pathway Inhibitors for Metastatic Castration-Resistant Prostate Cancer". Apparently I will need to be monitored in a hospital for 24 - 36 hours after treatment in the event of low blood pressure, etc., so I'm nervous about doing it. Has anyone else taken this treatment? Are there other standard, non clinical trial options instead?

[JolleySprings]

There are many trials available.

My husband just began one: DB-1311

The more info you have from biopsies and genomic testing the better it is to match you to a trial which potentially be of most benefit.

[brokenyoyo in reply to JolleySprings]

Thank you Jolley Springs!

[Poweredparaglider]

I start the same trial with Taxotere on Dec 30. Doing my pre-trial prep this week: urine, blood labs, EKG, bone scan, CT. Dr never mentioned hospital stay as part of the protocol, just 2 long days (7:45A-4:45P) at the facility. My wife met another trial participants wife in the parking lot. His PSA has dropped from "the hundreds to 20" in 3 months. Only problem she mentioned was fatigue, guess I'll find out.

Can't find too much info online, Dr said pharma company likes to keep it quiet till they are further along. This is the second part of a Phase 2 trial looking for marketability as a first line defense, thus the variability of treatments to see which might have a synergistic benefit. I am not happy about Taxotere again, but remaining SOC for me is Cabazitaxel. Not much choice. Good luck in your decision.

[brokenyoyo in reply to Poweredparaglider]

Great reply Paraglider. Thanks and prayers for you.

[VictoryPC]

Looks like you are dealing with chemically created CRPC. There are several good protocols involving breaks and intermittent therapy from the drugs to re-establish response and duration. This has worked for me.

[brokenyoyo in reply to VictoryPC]

Intriguing! Thank you

[MWPesaPharmD]

Post-ARPI and taxane (docetaxel) qualified you for Pluvicto but also Cabazitaxel (highest recommendation level in NCCN guidelines)

Have you had genetic testing done yet? It is strongly recommended (and under utilized) - Olaparib would also carry NCCN's highest recommendation if you had certain mutations

Unfortunately the visceral (lung) met would likely take Radium-223 (Xofigo) off the table

In short: Ask doc about genetic testing (if not already done), discuss Cabazitaxel, but trials remain a very viable and promising option as well

[brokenyoyo in reply to MWPesaPharmD]

Thank you! I appreciate your perspective.

[j-o-h-n]

Note: Did you write to Santa for a new one (times running out)?

Good Luck, Good Health and Good Humor.

j-o-h-n