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Hormone Refractory for years, now working again?

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Posted 7/21/2014 5:14 PM (GMT 0)

Hi All,

 

Just wondering  your feedback in regards to this.  My husband’s PSA came in at 227 a few weeks ago, but now it is 48.2!  This is after receiving Treslstar and starting Xtandi again. Trelstar had to be given in order for him to start the trial, in which he was denied. He has been hormone refractory for many years therefore he quit hormone treatment. Now the Oncologist is baffled is to what is working, the Trelstar or the Xtnadi or both?  Can a man who was considered hormone refractory have hormone treatment work again? And for how long?

 

Thanks,

Cathy

Posted 7/21/2014 6:26 PM (GMT 0)
Hi Cathy,

I'm glad to hear that this drug combo is working for him.

The Xtandi is doing what it's supposed to do - reduce PSA in a man who's become castrate resistant. No one can say how long it will continue to work.

I think most oncologists would have continued to give Trelstar even after the cancer has become castrate resistant. It actually is still working at reducing his testosterone output, which helps, even if the cancer has found ways around the diminished supply.

What is he doing for the mets - radiation? Xofigo? Is he taking Xgeva to prevent further skeletal events?

- Allen
Posted 7/22/2014 5:09 PM (GMT 0)
Hi Allen,

Thank you for your wise words. It makes sense that the Trelstar would decrease testosterone, I guess I wonder why the doctor’s quit giving it to him when he became hormone refractory. Maybe because at that time the Oncologist put him on chemo (Docetaxel?.) At least the combination of the Trelstar and Xtandi seems to be working for now.

Also, he did receive radiation years ago and Xgeva for bone mets during the past year, but hasn’t had any recently. He does have pain medication which he takes daily.

Thanks again for responding.

Cathy
Posted 7/22/2014 5:35 PM (GMT 0)
I think ADT is usually continued along with Taxotere or Jevtana. But it seems that it was stopped while he got those. Was there reason to fear enhanced SEs for some reason? I think it's a good question to ask his Onc.

Xofigo has been shown to prolong survival and decrease skeletal events. Also, a good thing to discuss with his Onc.

- Allen
Posted 7/23/2014 11:39 AM (GMT 0)
Allen,

Are there studies out there that show xgeva preventing bone mets?
Posted 7/23/2014 11:39 AM (GMT 0)
Allen,

Are there studies out there that show xgeva preventing bone mets?
Posted 7/23/2014 4:20 PM (GMT 0)
Yes, Jerry. In men with CRPC who are not yet metastatic but who are at high risk for bone mets, it delayed the appearance of the first met by several months. It did not increaase overall survival, however.

Denosumab and Bone Metastasis-Free Survival in Men With Castration-Resistant Prostate Cancer: Results of a Global Phase 3, Randomised, Placebo-Controlled Trial

- Allen
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