Bipolar Hormone Therapy, BAT for Prostate Cancer, BAT Patient Guide
Cancer ABCs
Bipolar Androgen Therapy (BAT): A Patient's ...

This complete guide to Bipolar Androgen Therapy (BAT) should be your stepping-off point if you are interested in using BAT to treat your castrate-resistant prostate cancer (CrPC).

Bipolar Androgen Therapy (BAT): A Patient's Guide
Radiopharmaceutical Treat
Cancer ABCs
Which is Better, 177Lu-PSMA-617 (Pluvicto) or ...

Several men have asked us if they are better off having 177Lu-PSMA-617 (Pluvicto) or Xofigo, a radiopharmaceutical drug that treats bone metastases. There is no simple answer, and the answer is not the same for each of us. Making a sound decision can be helped by understanding the mode of action and the limits of each treatment.

Which is Better, 177Lu-PSMA-617 (Pluvicto) or Xofigo (Radium-223)
PARP Inhibitors, Companion Diagnostics, BRACA
Cancer ABCs
Understanding the PARP Inhibitors - Who Will ...

LYNPARZA (olaparib) and RUBRACA (rucaparib) are PARP Inhibitors that were FDA approved in May of 2020 for men with castrate resistant prostate cancer who also have certain genetic mutations. The FDA also approved certain Companion Diagnostic genetic tests to go along with the decision making to use these PARP Inhibitors.

There is a lot of information now available with these recent developments which makes decision making confusing.

Understanding the PARP Inhibitors - Who Will Benefit?
Radiation Side Effect Man, Managing Radiation Side
Cancer ABCs
Managing Late Stage Radiation Side Effects

There are several possible side effects that can result from receiving radiation treatment. The most common of these side effects include the development of scar tissue that makes it hard to urinate (pee), defecate (poop), and in some instances, link the activity of either peeing and pooping together; bladder or colon bleeding and diarrhea. 

Managing Late Stage Radiation Side Effects
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Germline Mutations As Prognostic Indicators of Castrate Resistance

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In summary, these results demonstrate worse outcomes in men with germline BRCA2 and CHEK2 mutations compared with men without these mutations when treated with standard first-line ADT with LHRH analogs.

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Evaluating PSMA-Targeted Radionuclide Therapy

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This study did demonstrate that the level of PSMA expression of a man’s prostate cancer, the stronger the association with the likelihood of their having a PSA response. 

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Is There A Role for Testosterone Therapy in the Treatment of Metastatic Prostate Cancer?

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There has long been a discussion about the possible effects of using testosterone as a treatment for men with advanced metastatic prostate cancer.  In a poster presentation at ASCO 2019, it was shown that there are androgen receptor changes in the circulating-tumor DNA (ctDNA) in men with metastatic castration-resistant prostate cancer (mCRPC) treated with high-dose testosterone. 

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ADT With and Without Xtandi in Men with Metastatic Hormone Sensitive Prostate Cancer: The ARCHES Trial

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After a median follow-up of 14.4 months, the men who had Xtandi along with ADT experienced an improved radiographic progression-free survival advantage over those who had only ADT, regardless of their prior treatment. 

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Short Term ADT with Radiotherapy As Salvage Treatment After Surgery: Update at 9 years of the GETUG-AFU 16 phase III Randomized Trial 

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Findings confirm the better strategy for salvage therapy after failed surgery for prostate cancer is ADT along with radiotherapy,

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Darolutamide - Great Results From The ARAMIS Trial For Men With M0 Prostate Cancer

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The ARAMIS Trial showed that darolutamide increased overall survival for men with prostate cancer, it delayed the time to the use of cytotoxic chemotherapy as well as improving the important quality of life (QoL) measures of time to pain progression, and time to developing a symptomatic skeletal-related event.  

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The ENZAMET Study: Adding Enzalutamide to ADT in Metastatic Hormone-Sensitive Prostate Cancer Extends Survival

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The trial found that 80% of men with metastatic hormone-sensitiveprostate cancer who received enzalutamide (Xtandi) along with standard-of-care treatment (ADT) were alive after three years, compared with just 72% of men who received other nonsteroidal antiandrogens along with standard ADT therapy.

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An Important Update on the Use of Radium in Combination with Zytiga and Xtandi

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Make sure that you and your doctor use the bone-protecting approved medications (zoledronic acid or denosumab), especially for at least three weeks before using Xofigo (Radium-223).

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When to Start ADT With A PSA Only Recurrence

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Deferred hormone therapy (ADT) for in relapsing M0 (negative scans) prostate cancer patients is associated with prolonged overall survival (OS) measured from the time of local treatment, comparable to OS with salvage ADT in the contemporary experience.

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Reporting on Apalutamide (Erleada) for Castrate Sensitive Prostate Cancer

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The use of apalutamide (Erleada) improved radiographic progression-free survival with a 52% reduction in risk of death or radiographic progression; that benefit was observed across all subgroups analyzed in the TITAN TRIAL for men with progressing prostate cancer that is still hormone sensitive. The median radiographic progression-free survival was not reached in the apalutamide group and was 22.1 months in the placebo group.

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What We Are Missing In Prostate Cancer Treatments

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Prostate cancer treatments have been targeting the androgen receptor for over 80 years, and the vast majority of our new treatments also continue to target the androgen receptor.  Prostate cancer treatments have failed to include new classes of treatments when compared to other cancers. 

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Lower Doses of Zytiga with Food

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There was a small clinical trial, by Mark Ratain, M.D., of the University of Chicago, that suggests that it is possible to take a lower dose of Zytiga (abiraterone) along with a low-fat breakfast and achieve a response similar to the one we would expect to see with a full dose on an empty stomach.  

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Insights into the Management of Oligometastatic Prostate Cancer

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How best to treat oligometastatic prostate cancer is still not clear, but there are several on-going studies designed to determine what should be best practices.  Although not yet completed, these studies do indicate that metastasis-directed therapy (MDT) and local therapy targeted to the primary tumor (in the prostate gland) may be of benefit in the setting of oligometastatic disease. 

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