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).
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.
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.
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.
Abiraterone, enzalutamide, apalutamide, and docetaxel could be considered for this patient population (castrate sensitive prostate cancer patients), noted Taplin. "None of us can [confirm] that one [option] is better than the other; [the treatment decision] needs to be individualized [by weighing the] pros and cons [with each agent] for each patient," Taplin concluded.
The study concluded that adding Carboplatin to cabazitaxel showed improved clinical efficacy compared with cabazitaxel alone for men with metastatic castration-resistant prostate cancer. Although adverse events were more common with the combination, the treatment was safe and generally well-tolerated.
Shorter prostate-specific antigen doubling time was significantly associated with shorter metastasis-free survival and overall survival.
The development of metastasis was associated with a 3-fold higher risk of death.
The onset of non-metastatic castrate-resistant prostate cancer and metastatic castrate-resistant prostate cancer was associated with substantial cost increases.
Myovant Sciences has developed an alternative gonadotropin-releasing hormone (GnRH) antagonist named relugolix. Their still investigational treatment is an oral (taken by mouth) as opposed to an injectable gonadotropin-releasing hormone (GnRH) antagonist. It has completed a very successful phase III clinical trial called HERO has been submitted to the FDA for approval. We at Cancer ABCs believe relugolix will be approved by the FDA shortly.
ProACT™ (Adjustable Continence Therapy), which is a male stress urinary incontinence device. ProACT™ is a minimally invasive, adjustable, surgically implanted device. ProAct is designed to help a man control their stress incontinence resulting from the surgical treatment for prostate cancer or a radical prostatectomy.
“Based on our analysis of these real-world data, men with mCRPC who had immunotherapy added to their treatment regimen had a significant reduction in the risk of death at three years, regardless of the sequencing,” said Rana R. McKay, M.D., lead study author, and medical oncologist and assistant professor of medicine at Moores Cancer Center, University of California, San Diego. “This magnitude of risk reduction is a compelling finding, and additional analyses are underway looking at other variables that could impact outcomes.”
At ASCO- GU there was an interim data release from the LuPIN phase I/II clinical trial that holds great promise for men who have end-stage prostate cancer. The data analyzed the survival benefit of 32 men with end stage prostate cancer who were treated with the combination of Veyonda® and 177Lu-PSMA-617.
