Present course (12/26/16)

Present course of health events (as I see it on December 26, 2016):

  1. OHSU (Beer): In the short term he wants to start Enzalutamide. Optimal start date would be 12/28; but can wait until 1/13/17. Long-term plan is unclear, but I suspect PEMBRO trial. No scheduled appointment with Beer directly.
  2. UCSF (Small): I am unsure of their short-term recommendation; also unsure of their sense of urgency (perhaps, I should ask directly).  I know they don’t see a difference between Enzalutamide and Abiraterone. Scheduled to see them on 1/17/17.
  3. Insurance Company (MODA): I’ve received 2 denials to fund Enzalutamide (initial request and 1st appeal).  Unsure if OHSU is going to appeal a second time.  Interestingly enough, they will fund Abiraterone.
  4. Xtandi Support Solutions (Enzalutamide Manufacturer/Distributor): 
    • Currently working with OHSU & MODA to provide financial aid for drug purchase
    • Currently working with OHSU & MODA to provide ‘Quick Start Program’ (14-day emergency supply).
  5. Trails:
  • UCSF PMSA PET Scan: Did first one (awaiting interpretation).  Scheduled for follow up scan 2 to 3 weeks after start of either Enzalutamide or Abirateron.
  • OHSU Biopsy: Waiting for Enzalutamide OK AND whether lesions are large enough to biopsy. Scheduling Issues.
  • OHSU PEMBRO: Waiting for Enzalutamide OK, Enzalutamide failure AND reopening date.

Outstanding Questions (Inbox on Portals):

UCSF: Please interpret: Neuroendocrine marker AND PMSA PET Scan data.

OHSU:

  1. Eligible for PEMBRO trial if I were treated with Abirateron now and later with Enzalutamide? Timing?
  2. What did the most recent CT and Bone Scans (from Peace Health) tell us? Specifically, have lesions increased or are they large enough to get a sample for the Biopsy trial?
  3. Did you receive the PMSA PET scan report from UCSF (taken on 12/20)? What did we learn?
  4. Richard and I have been working in tandem to get XTANDI to approve a quick start program – seems to be going well. I assume we continue down this road?