Have anybody know starting Zytiga before using Casodex/Lupron or while Casodex/Lupron still works?

My father was diagnoised with Prostate Cancer IV on Jan 1st, 2014, they start Casodex/Lupron right away and it works lowing PSA. Now the doctor said there's a clinical trial for paitents who are just diagoised with PC IV whithin 3 months, to start on Abiratetone(Zytiga) right away and stop Casodex/Lupron. Have anybody know about starting Zytiga so early? I know the current news is that it is proved to be used after Casodex/Lupron or Chemo fail.

Thanks!

Jenny

Allen, thanks so much for replying! I feel a little bit ease now and need to search for more info on getting Zytiga with Lupron!

Sorry Jenny. I reread post. It's your father, not husband

Jenny,

Here's some more info that you may find encouraging. The researchers found that the combination of Zytiga and Lupron was able to render the tumors nearly undetectable (after surgery) in new high risk patients. Very exciting stuff!

Cytoreduction and androgen signaling modulation by abiraterone acetate (AA) plus leuprolide acetate (LHRHa) versus LHRHa in localized high-risk prostate cancer (PCa): Preliminary results of a randomized preoperative study.

Here's a video of the author talking about it.

Here's info on the big ongoing clinical trial as a result of those early findings

- Allen

Jenny,

The trial randomizes patients to receive either Zytiga + Lupron or Lupron alone. He and his doctors will not know which medicine(s) he is getting (it is double blind). Either way, he will be getting some great medicines. Your father should be aware that neither Zytiga nor Lupron are experimental medicines -- they're both available to be prescribed for PC right now. Lupron has been used this way for many years, and is probably what his doctor would prescribe for him anyway. What is new in the trial is the early use of Zytiga. As you can see in the other link, the early use of Zytiga seems to be amazingly effective. The way he might look at it is that he has nothing to lose by enrolling in the study, and possibly a lot to gain.

- Allen

Jenny,

There are many doctors who subscribe to that kind of sequential approach. The other way to look at it is that the sequential approach you describe is the cause of earlier resistance. The use of long-term monotherapies (i.e., GnRH agonists like Lupron alone) may cause the cancer to become resistant in the same way that bacterial resistance is caused by long-term use single antibiotics. The other approach - the cocktail approach - has been used successfully in other cancer chemo for years, and has been popularized for PC by Dr. Myers. The idea is to attack on multiple fronts so that the cancer will have difficulty evolving into resistant phenotypes. There is growing evidence too that the earlier many therapies are used, the longer they remain effective. This has recently been found to be true for Taxotere (chemo) and Provenge (immunotherapy), and now with Zytiga too.

Zytiga and Lupron may be an especially potent combination because they hit the androgen receptor from different directions. Xtandi hits the androgen receptor from yet another direction and is being paired with Zytiga in another clinical trial.

Other trials are looking at cocktails that include medicines that target certain tumor growth factors and immunotherapies. The hope is that in combining these medicines the cancer may go into remission for many more years than if they were tried sequentially.

Allen, what you said make sense to me now! Thank you!

Jacknsan, thanks for sharing your progress!