Experiences with

Castration

https://prostatewarriors.com/2025/03/07/secure-trial-update-promising-results-in-metastatic-castration-resistant-prostate-cancer/

Metastases-directed therapy in addition to standard systemic therapy in oligometastatic castration resistant prostate cancer: A randomized phase II trial (GROUQ-PCS 9). Presented at: ASCO GU 2025, February 13-15, San Francisco, California. Poster 22.

April.So I am in metastatic castration resistant stage.How long have you lived after same or same kind DX?

ATM mutations showed no significant effect on time to castration resistance (TTCR) or overall survival (OS), meaning outcomes are similar to non-mutated patients. BRCA1/2 mutations led to faster progression to castration resistance (shorter TTCR), but OS remained unchanged.

Participants will receive testosterone enanthate (500mg, intramuscularly) in 56-day cycles, alongside darolutamide and standard castration therapy. The study also examines safety, PSA progression, quality of life, and hormone kinetics.

The Phase 2 trial adds docetaxel to this adaptive approach, aiming to prolong the castration-sensitive phase of mCSPC and improve survival outcomes.

Interesting article about how PCa stem-like cells (PCaSC) are behind development of castration resistance and interaction with ADT timing/duration. It is a bit dense but I like the aspect of response predictiveness helping guide best treatment with outcome improvements.

Radiotherapy controls local disease, reduces symptoms, and may potentially delay castration resistance, warranting its consideration alongside systemic therapies in high-volume mHSPC." ...as you can imagine that "may potentially delay castration resistance" is quite interesting for us!

A real-world study of 41,379 prostate cancer patients found that GnRH antagonists lead to faster castration resistance than LHRH agonists, with a median time to CRPC of 10.9 vs. 17.3 months (HR 1.40, p=0.02).

A phase 2 clinical trial will start to assess the combination of opaganib (ABC294640) and darolutamide (Nubeqa) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Furthermore, our findings lay the groundwork for further research into the involvement of ERα and ERβ in PCa that results in its castration stage, CRPC, and emphasises the significance of ER distribution in various study models.

This study examined the relationship between drug efficacy in randomized clinical trials (RCTs) and real-world effectiveness for metastatic castration-resistant #ProstateCancer (mCRPC) drugs.

The ACCEL trial is a Phase 1 clinical study testing Actinium-225-labeled PSMA-62, a targeted radioligand therapy for oligometastatic hormone-sensitive prostate cancer and metastatic castration resistant prostate cancer.

If it was just my PSA going up it would be one thing but my testosterone is also going up so have I become literally castration resistant since my T is going up despite being on Orgovyx , hence my testicles keep producing T?

His cancer is still castration sensitive. He has previously had a prostatectomy, followed by radiation, and a few years after that 6 months of Lupron (which he doesn't want to repeat). He is currently on no medication but PSA is rising.

https://prostatewarriors.com/2024/11/20/phase-iii-trial-for-metastatic-castration-resistant-prostate-cancer-of-an-ezh2-inhibitor/

Evidence from HORRAD, STAMPEDE, and PEACE-1 shows improved local control, fewer genitourinary complications, and delayed castration resistance, though a clear overall survival benefit remains unproven.

We are talking about sequential therapy in this case, triplet is a different story (and it's used in castration sensitive setting). https://www.curetoday.com/view/arpis-may-improve-survival-in-some-with-prostate-cancer

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?

I am nervous if we wait 8 more weeks to be prescribed more meds he could be castration resistant by then.