BRCA 1 mutation

[Lawrencee]

ctDNA test revealed a BRCA 1 mutation in 11/23. Estradiol gel stop working in July of 2024. T level around 10. Onc started me on Lynparza / Orogvyx combination. PSA values ranged from 9 - 12 for six months. December 2024 psa droped from 11.4 - 10.1. January of 2025, psa went to 27. Onc thinks Lynparza stopped working, although, it never took my psa any lower than 9. PSMA scan on 10/27/2024 showed several spots, about 9 in locations mainly in muscloskeletal . No organ locations. Onc wants to try Xtandi, says about a 30%. chance it will work. Wanted to consider BAT therapy before Xtandi. BAT not offered at my facility. Thoughts?

[Tall_Allen]

We have actual clinical data that Xtandi+Docetaxel is effective:

prostatecancer.news/2022/10...

[Lawrencee in reply to Tall_Allen]

Thanks for the link to the information. I’ll share with Onc. Do you know where I can check into a BAT trial or any association thereof?

[petrig in reply to Tall_Allen]

There is also data that Nubeqa(darolutamide) is more effective than Xtandi(enzalutamide).targetedonc.com/view/darolu...

[P3Nav]

Xtandi and Lupron have been keeping my PSA undetectable after photon radiation. Have to take Xtandi on a non-empty stomach or you'll feel some discomfort for awhile. No side effects other than what super-low testosterone results in. My Onc said missing a dose or two, like I did when I ran out and needed a refill, isn't critical. Not super travel-friendly as the "pills" are the size of hummingbird eggs, and really bulk up the container they come in.

[Lawrencee in reply to P3Nav]

Thanks. Do you have a BRCA mutation?

[Seasid]

If you have BRCA genetic mutations you shouldn't use estradiol gel as an ADT,

[Lawrencee in reply to Seasid]

Right. My mutation is somatic in occurrence. I learned about that after I was notified about the BRCA mutation via a ctDNA test.