Started ABT-888 Phase 1 Clinical Trial, PSA rising rapidly

For those out there who may be interested in PARP inhibitors as a treatment for mPCa, I'll describe what I've been through in the last few weeks.

Background: I have widespread PCa all over my bones, recently in remission with ADT2 (lupron/casodex) which stopped working a few months ago. I've also been diagnosed with the BRCA2 genetic mutation which apparently makes a lot of difference in choosing the next therapy.

ABT-888 is in a class called PARP Inhibitor which has done very well in women with breast cancer. I'm in a phase 1 clinical trial to see what effect the drug has on prostate cancer. There is a belief that it could last for a long time. One onco said, "years and years" but that have been the case with breast cancer. The effect on prostate cancer is not as well understood.

So before Zytiga, Xtandi, Provenge, or any of the blockbuster drugs we've all been looking at, I'm going for ABT-888.

Last two weeks I went in for bone scan / CAT scan, then checked myself into a hospital where I lay in a hospital bed for a week taking the drug and getting my blood drawn every few hours. It was very tedious and there was only reality television and Seinfeld reruns to keep me company. Now I'm home and taking 200 mg of ABT-888 twice a day. No restrictions on food. So far no side effects except some fatigue.

I continue to take Lupron and Zometa, but casodex is over and out.

I'll keep you guys posted. I'm very nervous, depressed and scared so I could use some healingwell hugs right now.

I realize that ABT-888 is only for a small population and can't be see as a standard therapy for mPCa, but I hope some of you find this hopeful. For men with the BRCA2 mutation, it may one day be a standard of care as ADT is a standard of care for PCa.

John, hope this trial is a good one for you.. Sounds very personalized. There are several other trials that look promising.
Good luck on this one.

How can we even try to fathom the anguish you must be going through as you make these difficult decisions of what treatment to undergo next. You have been on my worry list since you first posted your story here. My sister died at forty of the ravages of breast cancer which had spread to the bones over her nine year battle and my first husband died of colon cancer which had spread to the liver at 31 so I thank you for undergoing these difficult studies which might help my children whose genetic makeup isn't promising. There are warrior women here who we constantly keep in our thoughts but I think we need to start a warrior men's list of those who despite less than promising odds keep at it and fight for every gain and never lose sight of those who might come after.

John, Thanks for the information. I wish you the best with this new treatment. BB

JohnKeats,

Entering this clinical trial may be of great benefit to you, but I think you deserve praise on behalf of all the men who might benefit from your (very tedious) efforts and taking a well-considered risk with this. I hope it will be a miracle cure, but even if it turns out to be something less than that for you, scientists will have gained more knowledge about how to treat it, and others will benefit.

Thanks everyone for the warm thoughts and kind words.

BRCA2 isn't a cancer mutation, but rather a gene mutation that results in the body's lessened ability to fight the growth of tumors. The therapy is exploiting the fact that the cancer cells has the mutation as well, and somehow cause the cancer cells to blow up and destroy themselves. That's the ridiculously simple version as I understand it.

I chose this path instead of Zytiga or XTandi because several oncologists were enthusiastic about it and told me that the clinical trials are far and few between and that horse on the merry-go-round won't come around very often, so I'd best grab it while it's here.

The other good news is that the cancer institute conducting the trial is about 90 minutes from my house, rather than 3,000 miles away in California. That was a big plus.

I'll continue to share my journey here for those who are interested in PARP for PCa. So far, no side effects at all, but I've only been taking it a few days.

What can you say about the side effects or maybe in the short future any results that can be measured would be nice for you and good to hear about. In case some others missed it Molecular Pathology shows how various genetic mutations are envolved in PCa's, most people have no idea which one cause their own PCa cause so far only a very few pathologist can do such, then how will the medical folks use that info, but some top oncologist do use such info.

www.yananow.org/Mentors/BonkhoffStrum.pdf   (Dr. Bonkhoff-Germany & Dr. Strum-USA)
www.nature.com/modpathol/journal/r21/n2s/full/modpath200811a.html   (Dr. Rubin)

Some genetic causes now have some specific known 'better' treatments, kind of a big deal. BCR genetics are mentioned within those, also.

Post Edited (zufus) : 5/7/2013 4:56:07 PM (GMT-6)

John,

I hope the trial is a huge success. Keep us posted and please stop by often to let us know how you are doing.

Jerry

Thanks Irmaly.

This is my first experience with a therapy failing and having to move on to a new one.

For the record, this is a dose escalation trial with the endpoint being time to disease progression as opposed to overall survival. I believe I'm getting the lowest dose (400 mg per day) and later stage people in the trial will get a higher dose, but I was told 400 mg has therapeutic value. The trial is only for a year but if my cancer goes into remission and stays there, they will petition the drug company to keep my supply going.

JohnKeats,

so excited you were able to get into this trial. Given the nature of your cancer, you need a secret new weapon that will knock it over. Science is developing at a fast pace, you are a part of something really important. Still remember the story of Dr.Casscells who was kept alive for over 10yrs by participating in various trials. When one does not work, move onto the next one. Cheers!

John,

Not sure if this is helpful or not, but I read about this and I remembered that you are dealing with BRCA gene.

Olaparib shows activity in advanced, BRCA1/2-positive prostate cancer:

http://prostatecancerinfolink.net/2013/05/16/olaparib-shows-activity-in-advanced-brca12-positive-prostate-cancer/

Jerry

Im not sure one can enter any new phase of treatment without some fear of it. for you and those who have to do such a thing I am in awe of your courage, and to post here keeping us informed is even more impressive.

How I wish somewhere and sometime soon one of you brave souls will report a %100 success which will pave a new road for all of us.

Healingwell hugs wrapping you in caring and well wishes.
I too, am envisioning this new drug bringing healing to you...