HealingWell
Search Close Search
☰

Combo of Xtandi and Zytiga anyone?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 4/1/2017 8:00 AM (GMT 0)
Dear friends,

After a year with Enzalutamide (Xtandi) my PSA is coming back. It rose in two months from < 0.01 to 0.03 and now to 0.12. Still low, I know, but I am concerned about the growth rate. I need to do something to stop that trend.

Before looking at other systemic options (Docetaxel rechallenge, Cabazitaxel, Xofigo, PSMA-Lu177 etc.) I was wondering if anyone here ever had a combo of Xtandi and Zytiga? Often there are cross resistances, so it might not help a lot to switch from Xtandi to Zytiga. Therefore I was wondering if a combo might be worth trying?

MD Anderson is doing a study about that combo (NCT01650194), but the results are not expected before September '17 and I can't wait that long.

Thanks for letting me know if you had such a combo and tell me more about your experience with it!

Best, m.
Posted 4/3/2017 9:08 PM (GMT 0)
Michael:

This is a really important question for anyone who is or may become castrate resistant. The issue was examined by the recently concluded PLATO Trial. This was a well powered, double blind, placebo controlled study.

The answer seems to be that for guys who become castrate resistant on xtandi, the use of an xtandi/Zytiga combo does not confer any significant benefit. Here is a link to a summary.

https://prostatecancernewstoday.com/2016/12/19/survival-benefit-not-seen-in-xtandi-enzalutamide-phase-4-trial-in-advanced-prostate-cancer

Hope this is helpful.

Simon
Posted 4/4/2017 3:09 AM (GMT 0)
Much would depend on your financial situation....Insurance would never pay for this...But if you have the money you can try anything you want...Have you looked into Provenge? Insurance WILL cover that...
Posted 4/4/2017 6:32 AM (GMT 0)
Thanks, Simon,

well, that answers my question. Bummer. I guess there might be exceptions but in general that combo does not look like a promising treatment option.

Fairwind,

Thanks for the post. I have looked at Provenge extensively - but the data is just not very convincing (survival benefit only 4.1 months, often no impact in PSA levels, trial design has been criticized).

Plus, I live in Europe, and Provenge is not available over here, i.e. I would need to go to the U.S. to be treated (and would need to pay for that). I was at MD Anderson for a second opinion and the doctors I saw there did not recommend Provenge.

But as I am running out of options I might reconsider Provenge. Can I ask you why you never tried it?

Best, m.
✚ New Topic ✚ Reply