Well, after 8 months on the trial for olaparib (PARP inhibitor), I was taken off it just before Christmas. While on the trial I’d had fluctuating PSA, but more up than down, and a little bit of progression on the scans. This was temporarily dealt with by an increase in the drug dose, but in December it finally ran out of steam. I feel that the drug kept the lid on things, without producing an actual improvement. The evidence now emerging suggests that BRCA2 mutations respond best to these drugs, and ATM mutations (like mine) not so much.
The MRI scans I had on the trial revealed that one of the mets in my spine could cause problems if not treated and tomorrow I shall start a short course of radiotherapy to sort it out. I’m feeling well overall although I am getting a few niggles from my back (dealing with that by paracetamol).
So what’s next? It could be cabazitaxel, but more interestingly, there’s a trial for an ATR inhibitor that I have asked to be considered for. There’s evidence emerging that this type of drug can produce good responses in ATM-mutated cancer (not just prostate). I’m now waiting to see if I might qualify for a place on the trial, details of which are here:
https://clinicaltrials.gov/ct2/show/NCT03188965
….and this describes some of the preclinical evidence:
http://cancerres.aacrjournals.org/content/77/13_Supplement/836