The treatment landscape of metastatic prostate cancer (2021, Review, Full Text)
A nice just-published review of approved therapies for advanced prostate cancer, including ongoing phase 3 clinical trials for metastatic prostate cancer.
I get the abstract only if I go to the paper's url directly. I get the Full Text if I go through Google Scholar here.
Djin69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx 2013 TURP for BPH (90-->30 g) no PCa 6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.020 (3y 7m)
Post Edited (DjinTonic) : 6/24/2021 2:21:42 PM (GMT-6)
<< "Therapies initially developed in later stages of the disease (metastatic castration resistant prostate cancer) have started to move earlier in the prostate cancer continuum, with new standards of care for metastatic hormone naive prostate cancer and non-metastatic castration resistant prostate cancer.">>
The quoted text above from the article has always been a source of frustration for me. Doing the trials for guys who need it most -- metastatic CR PCa -- is a good thing. But, then it takes a few years to do another trial to get the green light for use on hormone sensitive guys. Had I not delayed my palliative ADT treatment and instead started earlier with just Lupron, I would have not qualified for initiating ADT with Lupron + one of the second line ADT medications, and I would have missed out on the survival benefit that the early dual treatment provides. It's not really something I planned, but hopefully it will work to my benefit.
I guess we all tend to lobby for what we hope will help us as individuals, but I don't think it takes a genius to figure out that what works for a castrate resistant man will likely work as well, or better, for a hormone sensitive man -- without having to do another years long trial.Part I 2015, Age 54. Age now 61 PSA: 20.8 Bx: All cores G7 (4+3) RALP & Adjuvant RT Pathology: G8 (4+4)+5 PSA nadir: 0.1, steady increase
Part II 2019 Lupron/Xtandi, PSA: <0.01 2021: Reclast (zoledronic acid)
PS, there are SOC issues to protect doctors from prescribing unproven treatments, and of course insurance is reluctant to pay for unproven treatments, but in some situations these extra studies seem a bit silly. If it works for a CR man, it's probably going to work for a HS man. I think economics has a heavy hand in bogging things down. Maybe it works best that way... I don't know.Part I 2015, Age 54. Age now 61 PSA: 20.8 Bx: All cores G7 (4+3) RALP & Adjuvant RT Pathology: G8 (4+4)+5 PSA nadir: 0.1, steady increase
Part II 2019 Lupron/Xtandi, PSA: <0.01 2021: Reclast (zoledronic acid)
Appreciative of updates on the treatment landscape ...
Thankful to every fellow, past and present, who has stepped forward and participated in clinical trials. Debt of gratitude to each & all ... it has led to new treatments that have helped many readers here ... including me.
Most of the treatments we mention here have gotten FDA approval in the last two decades. When I was first diagnosed, XTANDI & ZYTIGA were just emerging as new breakthrough treatments.
I read an article then that described their approval as part of the "golden age" of the transforming landscape for new prostate cancer treatments.
I was my oncologist's first patient to sign up for the "early chemotherapy" approach when it was first recommended, following clinical trials. My progress since then is still being monitored ...
I was also my oncologist's first patient to undergo two newly approved genetic tests --- one involving blood samples collected at the lab, and another one involving tissue samples stored in the laboratory from my initial biopsy.
I was also the first patient at my treatment center to start taking ZYTIGA. To track my progress, I keep all my empty ZYTIGA bottles lined up on a shelf.
I am part of a treatment study being conducted by Mayo Clinic. All of my treatment data & health statistics are entered into an evolving database, that helps doctors make treatment decisions for others ...
Beyond that --- we have brothers in need, RIGHT NOW --- who need longer-lasting treatments and medications --- that can deliver knock-out punches to prostate cancer.
We need that next PRIZEFIGHTER treatment to emerge into the center of the ring ---- the treatment that can pack a mighty wallop and deliver that decisive knock-out PUNCH to resistant prostate cancer cells!
That will, indeed, be a heralded and glorious day, my compadres!
I have lost several close friends in recent years to prostate cancer --- some I had known for decades.
We all await those NEXT STEP treatments --- the awaited steps that will take us to the NEXT LEVEL in the fight against prostate cancer.
Here's to the next KNOCK-OUT breakthrough! CYCLONE ••• # Iowa State UniversityPSA At Diagnosis In Year 2013 : 138 Initial Diagnosis: Advanced Prostate Cancer, With Metastases In Both Lungs Age At Diagnosis: 48 years ADT Treatments: LUPRON, FIRMAGON, & currently ZOLADEX Subsequent Treatments: Chemotherapy (TAXOTERE) & ZYTIGA & RADIATION Additional Consultant - Dr. KWON - Mayo Clinic Current PSA Level: < 0.10 - Undetectable Range - Treatments Ongoing
Post Edited (Cyclone-ISU) : 7/1/2021 2:44:33 PM (GMT-6)
GoBucks said... Thanks Djin but I could not access the article through your link. Could just be me. I clicked your link and had 4 choices. All were just the abstract.
No guarantee, but you can try try registering for a free account at Science Direct, where you land when you click the article link in Google Scholar (post #1 above).
Djin69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx 2013 TURP for BPH (90-->30 g) no PCa 6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.020 (3y 7m)