Teddy9,
TA's list of trials does not include the one that I am enrolling in. It's called
"A Phase 3 Study of Androgen Annihilation in High-Risk Biochemically Relapsed Prostate Cancer." I first heard about
it in August although I did not yet qualify as my PSA was still below .5. At the recommendation of my RO, I did a Ga68-PSMA PET scan to look for oligometastates (1-3 hot spots) to see whether I might be a candidate for spot radiation, a controversial but interesting option for the ADT-averse. Although I spent numerous hours reading everything I could get my hands on about
the treatment of oligometastatic PCa, that option vanished as there was no sign of metastasis even using the razzle-dazzle new technology. After taking a short vacation from researching about
oligometastatic treatments and weighing its prospects versus the benefits/risks of ADT, I'm ready to go ahead with the clinical trial.
The trial has three arms: (1) degarelix (the "control" arm); (2) degarelix plus apalalutamide and (3) degarelix plus apalutamide plus abiraterone acetate plus prednisone. There's a two-thirds chance of being assigned to one of the two experimental arms with apalutamide, which TA and many others consider to be "promising". Unfortunately, you don't get to pick which arm you'll be in; you do, however, learn which arm you're in before the treatment begins. The hypothesis driving the trial is that hitting the post-SRT recurrent PCa hard (with degarelix plus) and early (before conventionally detectable metastases at the very least) will prevent or delay progression. Although I share your inclination to put off ADT as long as possible, I'm not going to wait for any more doublings. Sadly, we have a long way to go in understanding PCa progression so it's hard to know what the "degarelix plus apalutamide" approach would do to the cancer that's in my body, but the hope (upon which the trial is based) is that it will actually retard the process in a way that is more effective than waiting to a later stage in the progression.
Offhand, it seems to me that you may qualify for this trial. Your PSADT has to be <9 mos. and PSA >.5 so you're not quite there yet, but, unless you have a very wonderful reversal of fortune, your PSADT will carry you there fairly soon.
Let me know if I can answer any questions about
this clinical trial or the spot radiation debate. I got the Ga68 scan (which is what my RO at UCSF recommended) and researched what everyone (including our own TA) has to say about
spot radiation. My file on oligo is thick and I am still not certain what I would do if the results of my Ga68 scan had been actionable. As it turned out, from my failed SRT, I learned that my PCa is not in my prostate bed (else the SRT would have made a dent in my PSA) and, from the Ga68 scan, I learned they aren't yet big enough to be spotted on a Ga68 scan. Interesting.
Tomson