Dr Sartor raises questions about trip... - Fight Prostate Ca...

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Dr Sartor raises questions about triplet therapy as a SOC for MHSPC. What was the take home message of PEACE I ??

NPfisherman profile image
30 Replies

Greetings FPC members,

While I have STOPPED POSTING on cutting edge science, I will continue to report on interesting articles from MD's, etc... Below is an article from Dr. Oliver Sartor on the results from PEACE I. While some have jumped on board and said the new regimen should be docetaxel plus abiraterone/prednisone plus ADT, Dr Sartor remains unconvinced...--SEE BELOW:

practiceupdate.com/c/119674...

Dr Sartor raises the question of whether patients are really getting more "bang for the buck" being treated with docetaxel. I do wonder if this is in regards to CHECKMATE 650 and the decreased responsiveness to Yervoy and Opdivo by patients that had been treated with docetaxel.

At this point, maybe there is no take home message from PEACE I.....

Don Pescado

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cesces profile image
cesces

Thanks

6357axbz profile image
6357axbz

Thanks for this post Don. I appreciate hearing Dr. Sartor’s point of view. As an oligometastatic HSPC patient (OMHSPC) on abiraterone and ADT with prostate debulked by RT and all visible (GA68 PSMA Pet-Ct scan) mets zapped I am not anxious to throw docetaxel into the mix without solid evidence of a benefit. Neither is my MO, Dr. Corn at MDA.

NPfisherman profile image
NPfisherman in reply to 6357axbz

Like you, I am in no rush to add docetaxel....The results from CHECKMATE 650 and a recent Lu-177 trial showed people, with prior docetaxel were LESS responsive to those therapies as opposed to chemo naive patients. If radiopharmaceuticals and immunotherapies are the future of cancer treatments, then leaving those options open at a higher response rate makes sense. All IMHO....

Fish

NPfisherman profile image
NPfisherman in reply to 6357axbz

I think Dr. Corn is wise....as they say, if it ain't broke, don't fix it !!!! You are most welcome...

Fish

6357axbz profile image
6357axbz in reply to NPfisherman

Thanks For sharing your thoughts Fish

NPfisherman profile image
NPfisherman

No sabbatical... got an issue with a person taking my info here, and running "over there" presenting it as their own. Cujoe and I have "built the brand" here at Fight Prostate Cancer forum over the last 1+ years. My name is unimportant on the information, but the brand?? State you got it at Fight Prostate Cancer forum--THE BRAND. It leads people here. Don't act like you got it on your own for kudos from notable posters. Until that gets resolved, no cutting edge science.

Two banished guys should not have their science stolen and taken to the place where they got banished from and can not post. Very Unfair...At least, NOT WITHOUT THE BRAND !!! This is how we continue to build FPC.

In the meantime, I continue to report information. I could not have done it without cujoe, and his input is as important and valuable as mine.

Enough of my rant, I look forward to reading your nano technology post. The Science is Coming!!! Isn't it grand??

Fish

TFBUNDY profile image
TFBUNDY in reply to NPfisherman

It certainly is grand and a lot of us are very appreciative of the efforts of the few - Your good self, Cujoe, Nal and others. I look for hope, inspiration, knowledge, and the big gain - OPTIMISM. Keep digging guys and keep us informed despite slippery grandstanders sneaking about the site. Good work... Keep joining the dots... It's Coming!

NPfisherman profile image
NPfisherman in reply to TFBUNDY

Thanks TF Bundy,

It is coming !!!....and there is HOPE !!!... I am watching some of the new developments in nanotechnology with nanopartcles that can be loaded with various drugs, made from metals and silica and heated with ultrasound to kill cancer cells, new radiopharmaceuticals, vaccines, new drugs, new T cells, the list is astonishing... I have said it before... The Golden Age of Oncological Research is here!!!

Hope all is well with you and the grandchild....

Fish

TFBUNDY profile image
TFBUNDY in reply to NPfisherman

No grandchildren mate. The last one to suggest it is still eating hospital food. However, my daughter is marvelous and 5 years old next week. Think Rod Stewart... Mick Jagger... Only poorer. MUCH poorer...

NPfisherman profile image
NPfisherman in reply to TFBUNDY

Apologies... that's right....a child... well, she will keep you busy... a great age for children and beats teenage years by far..my one son left me closer to insanity during teen years....... You would have to have some BIG money to be like those guys... We would have to call you, Sir TF Bundy.... You have your daughter and that is a treasure.....happy parenting.... be well...

Fish

NPfisherman profile image
NPfisherman

I believe in the treatments of the future...Lu-177, AC-225, SBRT, immunotherapy, CAR-T or engineered T cells, macrophage stimulators, nanoparticles, and the list goes on... I suspect that chemotherapy tends to build resistance against some of those treatments. I am watching trial results for poorer performance from prior chemo exposure.

Fish

NPfisherman profile image
NPfisherman

Nal,

I am honored by your acknowledgement--Thank you !!!!..... nanotechnology is incredible. As you know, one of the things that researchers have found is that injecting human cancer cells into mice changes the environment of tumor cells, so that what works on mice may not work on men.

The ability to check treatments in an environment as close to that SPECIFIC person as possible is essential for a cure or improved treatment. This will provide that in my opinion. It will tell how that person will react to that treatment, what works best, and can likely be used to determine order of treatment for best possible outcomes. All the while, eliminating trial and error and the possibility of going in the wrong direction.

I also watch the science in Israel, and have been watching the development of NT-219, a drug developed in Israel that significantly enhances the response to immunotherapy drugs. The company, formerly known as Kitov, now known as Purple Biotech was to present interim data at ASCO 2021--see below:

globenewswire.com/news-rele...

You are so right... The Science is Coming !!!!

Fish

NPfisherman profile image
NPfisherman

BTW, looking strong as always....great pic...

Fish

NPfisherman profile image
NPfisherman

Indeed, if you take information from someone else and post it....acknowledge the contribution... or at least where you got it....

Four months on a post... dang....I'll keep my peepers open for that post for sure... I know what you mean when you say you need to get it just so....in a particular way for everyone... It is a calling to post and share information... Thanks for all of your efforts...

Shalom, my friend....

Fish

cesces profile image
cesces

If there's a rational excuse to avoid or defer docetaxel, why not.

NPfisherman profile image
NPfisherman in reply to cesces

I think if you have a low disease burden then using docetaxel early may NOT make sense like under the STAMPEDE trial... There are questions that tom67inMA raised --" So is it the chemos that are causing the problem? Or aggressive cancer leading to more chemo being used early?".

If Dr. Sartor has concerns, then a rush to embrace a new triplet therapy needs to be evaluated further. ALL IMHO !!! That guy is a genius and a leading researcher and physician...so if he says...."Not so fast!!", then let's see more evidence...

Don P

GreenStreet profile image
GreenStreet

Fish just to let you know many of us really appreciate and value your posts on future science. Same with Nal too.

NPfisherman profile image
NPfisherman in reply to GreenStreet

Thank you Greenstreet.... We do try and it is a calling.... when people take information, run to another poster, take credit for THE RESEARCH, and do not reveal this forum as the source of the info, then I have issues with that happening. Cujoe does yeoman work here with me and the success that this forum has had in building up followers/readers has been strong based on our work.

The person that did this has denied 2000+ people my science posts for now... I guess they are not losing sleep over it... Nal put out some great science coming out of Israel. As I say--The Golden Age of Oncological Research is here!!!

Fish

tom67inMA profile image
tom67inMA

Well I'm screwed having just finished my fourth chemotherapy, LOL! But seriously, a lot of trials have exclusion criteria for >2 chemos, so that's going to limit my options going forward. On the other hand, I wouldn't be alive today without all that chemo (perhaps excepting the taxanes) and the really good trials weren't yet ready to recruit subjects late last year when I really needed something, anything, to keep me going.

One of the other problems is I had docetaxel early on because my oncologist suggested it, and I was a young and naive cancer patient at that time. I'm still relatively young and naive with regards to neuroendocrine cancer because there is just too much happening and at lot of the work is in progress and hasn't been reported on yet, so I rely on Dr. Beltran to have information that isn't publicly available.

I'd also like to point out that many in the STAMPEDE and PEACE-1 trials are not having recurrences for 5+ years, while I'm barely past 2.5 years and have had four chemos and just started my 3rd recurrence. So is it the chemos that are causing the problem? Or aggressive cancer leading to more chemo being used early?

NPfisherman profile image
NPfisherman in reply to tom67inMA

Tom,

I have followed your path for a while... It is hard when you have your back against the wall many times in a short period of time, and yet... Your spirit and courage continue to be the perfect example for all of the fighters on these forums. Never quit....never surrender...

I think we are forced to make tough choices along the way and none of us are Oncologists. You made the best choices with the information available at the time.

Your question is a good one, and I guess we will find out over time... Does chemo create problems by sensitizing cancer cells and creating resistance to other treatments??

I reviewed your profile...You had aggressive cancer from the start and then got another-bladder cancer....Have they ever done a prolactin level on you?? Just wondering... Sometimes prolactin can be a driver in prostate cancer...

You see Dr Beltran so you are in good hands. She is the leader in NEPC....

Keep up the 5Ks and keep blogging. Best of luck to you....

Fish

cujoe profile image
cujoe

Welcome Back to the Fight, Comrade!

NPfisherman profile image
NPfisherman in reply to cujoe

"Na vashe zdorov'ye, comrade..." as they say in Lady Margaret's native tongue....

Fish

cujoe profile image
cujoe in reply to NPfisherman

то же самое для вас, мой друг

NPfisherman profile image
NPfisherman in reply to cujoe

Spasibo., comrade....

NPfisherman profile image
NPfisherman in reply to cujoe

In all fairness to you, I could not let you carry that load alone.... we came here together and should continue onward, even if I am in reporter mode for now, not scientist or mad scientist.... I reached out in a nonthreatening message to the offending party, but no response... it will get resolved... I care about what we built... take our information other places is fine, but put the brand name on it....FPC... you got it here... give credit to the brand... it drives interest towards FPC...

Have a great day, amigo...

Fish

cujoe profile image
cujoe in reply to NPfisherman

Just curious. What happened to the earlier post?

NPfisherman profile image
NPfisherman in reply to cujoe

I take it the other party deleted along with some other recent posts.. it is what it is... I am more interested in the brand and not my name on science from here...

Fish

NPfisherman profile image
NPfisherman in reply to cujoe

BTW, it was not the first time this happened... it was overdue to put my foot down...

cujoe profile image
cujoe in reply to NPfisherman

I know well what you mean. The lack of real curiosity and/ or enthusiasm for exploration by people with an incurable disease is incredible to Moi. I even see it within my family, which is universally cursed with various cancers. How many times do we see someone ask a question here that a simple search engine would answer for them.

It's one thing when it is a newly diagnosed individual or caretaker who is in the midst of the diagnostic fog and trying to understand the complex nature of their disease and treatment options, but quite another when it is someone who replies regularly, but never spends the time to actually do the research or even put together a post to link to a web source that might be informative to others. If they were 12 years old and living at home with mom still cleaning up after them, it would be one thing, but everyone at these forums are middle-aged or older adults. Individual laziness and lack of initiative are two phrases that usually come to mind.

Anyway, it is very good to have you back online and helping us keep up with the science. I hope your travels were fine ones and some memorable times were had along the way.

BS /SW - Buon pomeriggio, Capitano K9

NPfisherman profile image
NPfisherman in reply to cujoe

Ahhh Capitano K9,

Like I say, you get it here....give credit where credit is due....our forum... it is just being responsible as a forum member and researcher...

Have a great afternoon as well....perhaps, a nice red Italian wine with supper on board the ship and relaxing on deck afterwards... try not to hurt your neck looking at bikini clad women...

Fish

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