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Seeking opinions on my Dads options - low PSA metastatic prostate
Prostate Cancer | Last Active: Jun 4 10:59am | Replies (9)Comment receiving replies
Very thorough explanation. It’s fantastic that you’re in the game advocating for him.
> is the metastases currently only to bone?
Regarding Scenario #2 (….insurance will not approve Pluvicto until he has tried an oral androgen receptor (Xtandi) AND a PARP inhibitor. In order to have Pluvicto as a future option, they are starting him on Xtandi now to fulfill insurance requirements and then eventually adding in Talazoparib in combination. The issue here is the high toxcitiy that comes with that combo.)
Since the insurance requirement is to “try an oral androgen receptor (Xtandi) AND a PARP inhibitor), I’ve known doctors to “try it” with only once, then immediately - with the requirement technically being fulfilled - to go to the next desired treatment (there bring no requirement to go through multiple rounds of Xtandi and/or Talazoparib, given the known quality of life impact).
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@brianjarvis from what we know now it is in his bones and lymph nodes. however his doctor continuously speaks on how it’s important my dad gets treated with medications that have blood brain penetration… as for the approval of Pluvicto, he said he would want to have my dad on Xtandi for at least a few months before going to Pluvicto. we asked if we could technically do “one” treatment and request Pluvicto, but he said he’d want to see how he tolerates it for a few months. I’m not sure how I feel about that