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Nilutamide ( Nilandron) or Zytiga when Casodex fails

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Prostate Cancer
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Posted 8/18/2014 4:29 PM (GMT 0)
I am interested in any results from stopping Casodex and changing to Nilutamide. After one yr. of <0.1 psa on Firmagon, I took a 5 mos. vacation. Psa returned at 0.32. Added Casodex and the psa increased monthly to 0.42, 0.76, and 0.92. I stopped the Casodex and the psa dropped to 0.74 but then increased to 1.01, decreased to 0.9 and then increased to 1.44. Have now added Nilutamide to Firmagon and Avodart. Surgery 5/12, IMRT 11/12, Firmagon since. Gleason 9; neg nodes; bone scan 2/14 neg. Should I expect a psa decrease on Nilutamide or should I go to Zytiga immediately. How long does one take Nilutamide? Next psa is 8/27/14 Appreciate any input. Pmikey
Posted 8/18/2014 5:19 PM (GMT 0)
It's anyone's guess whether nilutamide will feed the androgen receptor the way bicalutamide did. If it does, enzalutamide (Xtandi) may be a good next choice. (All the __utamides have a similar mode of action.) It is a very powerful androgen receptor blocker. Zytiga has a very different mode of action - it prevents your body and the cancer from synthesizing androgens. Both Xtandi and Zytiga together may be more effective than either alone - there are clinical trials now to determine that.

- Allen
Posted 8/18/2014 8:30 PM (GMT 0)
Yes, I tend to think of the former Lupron and Casodex combo as the precursors to the new Xtandi and Zytiga being tested in clinical trials, with the latter two both much more powerful but somewhat similar in what they are attempting to accomplish, than the former two.

LupronJim
Posted 8/18/2014 11:19 PM (GMT 0)
From a personal perspective, please read signature for my husband below. He was on Casodex and Firmagon. When the PSA went up after 5 months, Casodex was pulled with no response. He then went on Nilutamide, which "worked" for just over a month I believe. He is now on Zytiga, Firmagon, Avodart and metformin and still his PSA is rising. Next up is Xtandi and possibly Zytiga concurrently, since we have both covered. Wishing you the very best!
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