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Xtandi Effectiveness...

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Posted 10/17/2017 5:53 PM (GMT 0)
While discussing my future treatment with my MO, he said Xtandi would probably be effective if my mets are limited to the bones. But if mets are detected in soft-tissue organs, then forget Xtandi and move directly to Chemo as the Xtandi is not effective against that type of metastasis...Zytiga, which gave me a nice two-year remission, is no longer working...He was luke-warm about Provenge but that's a possibility also.... I'm waiting for scan results, bone scan done, PET-CT coming up..

The question being, have any of you advanced PC guys had any luck with Xtandi when you had mets in places other than bones?
Posted 10/17/2017 7:26 PM (GMT 0)
Xtandi usually doesn't work for very long after Zytiga has failed (cross resistance). It's possible that chemo before Xtandi may help it last longer.
Posted 10/18/2017 4:35 PM (GMT 0)
TA:

What about the reverse? How effective is Zytiga after Xtandi has failed?
Posted 10/18/2017 4:58 PM (GMT 0)
john16-

Either way. Each creates cross resistance to the other. That doesn't mean it won't work at all, just not for very long. Experimental antiandrogens like apalutamide and darolutamide may be less cross-resistant - that's the hope, anyway. It's also possible that if used together, rather than sequentially, the combination might work longer. There are clinical trials to determine all these things.
Posted 10/18/2017 6:46 PM (GMT 0)
So if they discover that if both Zytiga and Xtandi are used together, I wonder if the two drug companies will offer a volume discount ?? At some point, the insurance companies are going to put their foot down if Congress does not do something first.....

They are never going to CURE cancer messing around with hormonal therapies. All they are doing is extending patients lives for a few months, maybe a year or two, while they extract $billions" of dollars from Medicare or private insurance or both ! We expect healthy young people to buy health insurance at very high prices so that we can have access to these drugs....There has to be a better way.....
Posted 10/19/2017 1:42 AM (GMT 0)
I have not heard of the idea that Xtandi works better on bone mets vs. lymph node or other soft tissue mets. I wonder, "How would it know the difference?"

In my case (see below), I had a rising "resistant" PSA, and about 10 mixed, active "hot spots" as confirmed by a Ga-68 PSMA PET scan, involving both bones and lymph nodes (lungs and liver are clear), when I started on Xtandi at the end of November 2016, with a PSA of 95. After 11 months, my PSA is down to 1.4. A NM Bone Scan and regular CT Scan in the Spring of 2017 were essentially "stable", and unchanged from a year earlier.

(I was diagnosed in 2013, before the results of the CHAARTED, STAMPEDE, and LATITUDE Clinical Trials started making their way into clinical practice. Were I similarly diagnosed today, I would have considered Chemo earlier, rather than later.)

Charles
Posted 10/19/2017 3:54 AM (GMT 0)
Hello Charles...I'm thinking of giving Provenge a shot...What are your feelings about it? If PSA means anything, it looks like the Xtandi did the work, more so than the Provenge..My latest bone scan had a few new mets show up..PET/CT coming up shortly to check the liver and lungs..My oncologist feels that mets in those organs are much worse than bone mets and should they be detected, chemo is my only real choice...I have a second oncologist I'm going to talk with, just to keep the first one honest...
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