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I just got approved for XTandi pre-chemo

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Posted 12/21/2012 8:09 PM (GMT 0)
Bizarre bit of news today. I've been experiencing a PSA rise in the last few months so my doctor cycled me off the Casodex for six weeks and then put me back on starting two days ago at triple the dose.

Meanwhile, I somehow got approved for XTandi at $35 a month co-pay even though I have not been through chemo. The pills arrive at my pharmacy on Monday. These pills were ordered by my second onco.

So now I'm faced with the dilemma of continuing with the Casodex to see if my PSA will start to fall and buy me some more time on more traditional hormone therapy. Or I can shift gears and start taking the XTandi.

Either way, I'll ask advice from both my oncos. But I thought you all may find this interesting that I got the drug without any problems and I'll be holding them in my hands next Monday. An early Christmas present.
Posted 12/21/2012 9:02 PM (GMT 0)
Congrats on receiving the Xtandi. (I thought label was only post-chemo now. Maybe you got it off-label.)
Anyway, good luck with whichever you choose.
Posted 12/21/2012 9:05 PM (GMT 0)
Seems unreal to get it easily, this drug usually costs $7,350/mo (mdv3100) right? Since it binds to the AR receptor better than casodex or anything invented thus far, seems like logic says stop casodex and go directly onto this, see what the other onco says on this. MDV3100 has been also called super casodex and is in the same family (enzalutamide=mdv3100=Xtandi) is in the 'mides' family (bicalutamide, flutamide etc.) It may work way better than casodex, it is supposed to. Glad you got this and hope it does work for you asap. You can educate us on how it works for you or side effects if known.

12.1 Mechanism of Action

Enzalutamide is an androgen receptor inhibitor that acts on different steps in the androgen receptor signaling pathway. Enzalutamide has been shown to competitively inhibit androgen binding to androgen receptors and inhibit androgen receptor nuclear translocation and interaction with DNA. A major metabolite, N-desmethyl enzalutamide, exhibited similar

in vitro activity to enzalutamide. Enzalutamide decreased proliferation and induced cell death of prostate cancer cells in vitro, and decreased tumor volume in a mouse prostate cancer xenograft model.



Hoping you the best.

Post Edited (zufus) : 12/21/2012 2:09:48 PM (GMT-7)

Posted 12/21/2012 9:11 PM (GMT 0)
Thanks. A year ago MDV3100 seemed like some experimental pipeline drug I will get years from now after I've been through Provenge, Chemo, Zytiga, ARN, TAK, etc.etc. It also had the dark shadow of only a few months survival benefit hanging over it. The thought of taking it so early is a little unnerving.

I got the drug through Penn Medicine in Philadelphia. I assume it's off label since I've never been on chemo.

I would be honored to report how well it works on someone in my staging and condition. I hope it works for as long as possible.

Some of the men in the clinical trial (AFFIRM) had a median survival of 18+ months, so I'm assuming that there's a possibility the drug will last that long on me, and by the end of my run on it, I could be on something else, like Zytiga.

Does that sound plausible? Possible?
Posted 12/21/2012 9:51 PM (GMT 0)
That's great!

Ditto on what Zufus said.

At my last appt with Myers, he was really excited about Xtandi.

Keep us posted and here's to it working a long time.
Posted 12/21/2012 10:14 PM (GMT 0)
John,
You are still our "poster" boy.."One for all"..Really excellent that you let BUD know what's going on--maybe a good option for him!!
Bill
Posted 12/22/2012 2:17 AM (GMT 0)
You have to wonder what goes on backstage when these decisions are made..One man gets turned down flat, sorry, you don't meet our qualifications..The next guy, $35, here are your pills....Did ANYONE pay the seven grand? Or are the prices for these drugs variable and subject to change according to which way the wind is blowing?
Posted 12/22/2012 2:23 AM (GMT 0)
Congratulations and good luck to you.

david
Posted 12/22/2012 3:09 AM (GMT 0)
My husband was on Zytiga for 6 weeks.By worked, PSA started to rise again after 6 weeks...quickly..up to 1098, CTC up to 132.
After 4 weeks of Xtandi, PSA down to 464, CTC down to 11.
PSA is checked every 3 weeks just as if on chemo. dec. 27th is next PSA, praying for a reduction in both.
Our first copay was $12.50, second copay was $60.00, same insurance Medicare and supplemental. Meds come fed ex to my house. Need to see what 2013 copay wil be. Our copay on Zytiga was $847.50 a month.
Posted 12/22/2012 9:39 PM (GMT 0)
JohnKeats,

Best of wishes on your new journey with Xtandi.

Kick the beast to the curb!
Posted 8/17/2013 10:40 AM (GMT 0)
I have been on Xtandi pre chemo for 4 4 months PSA was on the way up 79 when I started Xtandi now 9.2 and still dropping . The first 2 months were difficult as the side effects beat me up pretty good..make sure you eat before you take it..expect fatque flushing and all the side effects listed ..over time they will calm down..the drug is worth taking ..good luck and let me know if you have any questions
Posted 8/17/2013 11:51 AM (GMT 0)
Bpanas,

Welcome to Healing Well. It's a great place for info and support. Feel free to start a new thread on your specific dealings with PC... sorry you have to check in with us, but welcome...

Jerry
Posted 8/17/2013 2:50 PM (GMT 0)
John Keats,
Xtandi wins - hands down. Congratulations.
BTW- as tumors become castration-resistant that can start to feed on Casodex, so sometimes PSA will go down just because you stopped taking it.
- Allen
Posted 9/9/2013 5:22 AM (GMT 0)
I've been taking Xtandi now for 5 weeks now also pre chemo. I was a little freaked out when I first got the pills. I got a call from a pharm. that is in a different state that had been sent a prescription from my oncologist. ( I was told by my oncologist to enroll in the program with them at that was all I was told about it by the DR.) Anyway they asked me to verify a few question's and then I was told that I would be recieving a package by UPS and that I should start taking the pills right away. Info about the drugs would be included and every month they would call me to verify I still needed the next months pills shipped to me. ???? What?? I had no idea what was going on. I called my oncologist and was told by his nurse that he wanted me to start this new treatment. Then I got the package opened up started reading the info and that's when I got freaked out. I read that it is approved for treatment of prostate cancer after recieving chemo. I called my Dr. again and was told take them anyway that's just what they have to say because the FDA makes them say that because thats what has been clinically trialed. Anyway took me a month to say got to do something. I have been so sick and very tired. Not to mention the emotional and mental effects on my attitude and overall feeling about everything. I'm going to give it a couple more months before I can say if I'm going to stay with it. Don't know if it has changed PSA cause I haven't had appointment til Oct. with oncologist. Good Luck I hope it works as well as it is said to.
Posted 9/10/2013 12:30 PM (GMT 0)
Well I asked my dr the same question and he told me that casodex works for most people and it only cost a fraction of the 7500 that Xtandi does. I am 5 months into Xtandi per chemo PSA is holding at 10. But each day it gets more difficult to deal with this. My attitude sucks..and all the pain meads I require makes me nervous.
I still have BTP that requires me to visit the er for I've pain meds.
Basically life sucks every day I wonder what is next! Hang in there
Posted 9/10/2013 11:32 PM (GMT 0)
Since I had just finished provenge my Onc started me on Xtandi since it requires no steroid that could hamper the provenge results. My psa was rising and after 3 weeks on the drug it stopped the rise. I thought I was going to have to reduce the dosage to 3 pills as the fatigue was kicking my butt. However, I stayed with the full dose and now after 7 weeks the fatigue and other SE's don't seem to be any worse than casodex. I hope that it works for some time.
Posted 9/11/2013 10:49 AM (GMT 0)
How are the side effects from the province everything j have taken has beat me up pretty good and province will prolly be next if my PSA doesn't hold. This stuff has got me real nervous .. bone metastases have resulted in a hip replacement and horrible bone pain .. gosh I sometimes wish this was over ..
;*(
Posted 9/11/2013 9:45 PM (GMT 0)
I'm not well educated on prostate medicine treatment, but I wish you all the best with whichever you choose!

Three things I wanted to point out though:

1- Consider eating more tomatoes, as the lycopene in them is really good for your prostate... you never know, it could help with your PSA levels.

2- Same thing with walnuts. A study from Texas showed that men who ate roughly 2 ounces of walnuts every day were less likely to develop prostate cancer later: link deleted.

3- Lastly, knowledge is power. So be sure to educate yourself on the stages of prostate cancer, just in case it becomes an issue in the future: link deleted

Good luck with the medicine choices and be sure to treat your prostate well!

Hello again, Jake. We're still waiting for you to convince us you don't have financial ties to the HIFU treatment facility you keep linking to. nono Until you do we'll keep deleting your links. Hope you are well. Have a nice day! -- PeterDisAbelard (Moderator)

Post Edited By Moderator (PeterDisAbelard.) : 9/11/2013 4:04:20 PM (GMT-6)

Posted 9/11/2013 10:20 PM (GMT 0)
That is excellent news brother congrats. Xtandi will beat this crap
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