Last lap?? Need expert advice. Tall Allen or ... ? Hate to bother you at Christmas.

[bloodyveinpoke]

I was about to adjust my Lynparza regimen in hopes of improving blood numbers, and maybe reducing side effects, when I found PSA increasing. Wondering if this is end of its effectiveness, and are there any alternatives?? (p.s. Am 81 with heart problems as well, with labile hypertension and moderately successful open heart surgery 2015.) /// History: prostate removed 2006. 2019 found PSA at 85, and recurrence already metastatic. Started ADT and series of drugs, including abiraterone. Found I have Braca 2 gene, and was started on Lynparza May 2020. PSA moved from 3 in January 2020, increasing to 31 in June, gradually declining to 7.9 in November, but then rising to 15.4 in mid-December 2020. Blood numbers poor, with hemoglobin and platelets declining, and GFR now in low 20s. Any advice?? Feel like docs have given up, and wonder if there is another strategy to try?? I have to insist on PSA testing when I have blood work done bi-weekly, else I would not even know of the recent changes. Presuming I should remain on 150 mg x 2 of Lynparza -- not more, not less??

[Tall_Allen]

I'm Jewish, so I don't mind responding during Christmas.

PSA is only one biomarker. The real deciding factor is "clinical progression," which could entail pain, bigger or more metastases on scans, interference with organ function, changes in bloodwork, etc. Lynparza has a high toxicity profile.

If it has stopped working, chemo with a taxane plus carboplatin may be a good next step. It seems to work on cancers that respond to PARP inhibitors. The nice thing is that resistance to one doesn't seem to make one resistant to the other.

[bloodyveinpoke in reply to Tall_Allen]

Thank you so much for the prompt reply, as I see my oncologist tomorrow, and will run this idea by him. Am so glad to know there may be an alternative treatment.

[Hidden in reply to Tall_Allen]

🙏Shalom

[LearnAll]

The eGFR below 20 means you are already in kidney failure. .so you got to watch carefully and avoid any more kidney toxic treatments. Both Red cells and platelets going very low is also a sad event as it indicates bone marrow failure. Wish a miracle for you ..from God on this Christmas day. Surrender and pray to God and hope for the best.

[Hidden]

What a job to have at 81...you are one strong man . I have no medical advice . The doctors are caught up in their own heads . I was written off early on by the Drs.. heal and live anyway you choose . Others shall chime in . Merry Christmas and good luck .🎄

[bloodyveinpoke]

I just had a visit with my MO, and he suggests getting ready for Hospice, and that any high powered therapy would likely just kill me or put me in the hospital. I will run your idea of switching from Lynparza to Rucaparib by him, however. Thank you very much for your thoughtful answer.

[monte1111]

Ouch. Hope you find something that works. Merry Christmas.

[j-o-h-n]

May you beat the odds.... and stay with us..... 81 a (British) war baby......?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/24/2020 7:33 PM EST

[zengirl]

Not sure if your Braca2gene is a mutation from treatment or born with it. My husband was a mutated Braca2 gene and it wasn't helpful. It was very, very harsh on his system and he has lost his sense of smell and taste since then. There is a cousin to Lynparza that is out and I hear is better. You are a warrior and screw the bloody doctors for bringing up anything other than fighting this thing. My husband has been fighting for 24 years although we are in some very difficult territory, now. To my fellow Jewish warriors - a belated Happy Hanukah and for all a Merry Christmas and brighter New Year.