next steps-failing Erleada

[Juneau14]

hi all,

my father was diagnosed w stage 4 prostate ca may 2022. Gleason 9, psa 150s, diffusely metastatic (spine, lower/upper extremity, LN), genetic testing negative.

unfortunately his MO was not well versed on triplet therapy; he underwent 6 rounds of taxotere and started on Luperon q3 months. Nadir i believe was about 0.05?

numbers began to climb after about 1 year of Luperon; added Erleada. Now over the last 8 weeks psa doubling and tripling, at .97 currently.

Thoughts on next steps; trial of taxotere/jevtana?

I'm assuming switching ARI will likely not have a huge effect as it's all same/similar mechanism of action for cancer that's castration resistant now...?

Pluvicto (if even possible to get)...provenge?

[God_Loves_Me]

I am not DOCTOR, I am not MEDICAL Advisor.

- Try to get PSMA PET SCAN Immediate. I hope you get clear picture of METs. if you find METS less than 5. May be you can go for SBRT radiations. Setup Appointment with Radiations Oncologist + Provenge, May be

- I do not see in your Profile. Does he tried Zytiga , Xtandi or Nubeqa. ?

- Pluvicto is actual good options as well

- Think about clinical trial if you want to keep pluvicto for future. Like AMG 509 , ARX 517 and FPI-2265 (225Ac-PSMA-I&T)

[Tall_Allen]

Many good options. I like some of the Xofigo combinations:

prostatecancer.news/2021/02...

Or docetaxel+enzalutamide as in the PRESIDE trial:

prostatecancer.news/2022/10...

Any clues from genomics?

[j-o-h-n]

Greetings Juneau14,

Would you please update your dear Dad's bio. All info is voluntary but the bio will be helpful to you and to us members. Thank you!!!

Give our kindness regards to your Dad. (You're a great offspring, so keep up the good work).

Good Luck, Good Health and Good Humor.

j-o-h-n