Unwarranted conclusions about oligometastatic treatment

George_ said...


This group where the decline in the PSA value was observed had higher prolactin values than the rest of the patients in the study.

So it is likely that the combination of Casodex and Tamoxifen was required to achieve the decline in PSA value reported by Traveller58.

George

That's another interesting twist. Were I to go on Casodex I'd want Tamoxifen also to counter gynecomastia, but hadn't thought of Tamoxifen as also possibly reducing PSA. FWIW I looked up Traveller 58 in the members directory. I see that he is in Turkey, which may explain why he is on Casodex in the first place, given it is used as a standard treatment in much Europe. If he's watching this forum at all, I'd like to hear from him.

I see that most of the papers on Pubmed relating to Casodex (bicalutamide) monotherapy are 15 or more years old, which suggests that enthusiasm when it was relatively new has waned since.

I did find this paper from 2014 - a review of 11 studies involving 3060 men. It concludes anti-androgen treatment is less successful in terms of overall survival and slowing clinical progression. However, this paper addresses patients with metastatic recurrence, not patients (like me) with BCR. Also it notes one of the main areas of dissatisfaction of patients with the anti-androgen treatment was breast pain and enlargement, which I believe these days can be minimized with Tamoxifen, and to me, seem less onorous than some of the nasty side effects of Lupron or it's equivalents.
/www.ncbi.nlm.nih.gov/pubmed/24979481
Jim

Tall Allen said...

Bohemond - No, he is being treated by Howard Scher at MSKCC in NYC, not in Turkey.

Thanks. The guy in the member directory must be someone else. Intriguing that he is getting this treatment in U.S. where it is uncommon.
Jim

Bicalutamide (Casodex) has been around a long time...Two newer drugs, Zytiga and Xtandi both work the same way but MUCH better and more effective...But these drugs are only used after a patient becomes hormone refractory and are seldom if ever used as a primary treatment mainly because insurance companies won't pay for that "experimental" use of these very expensive drugs..If Zytiga and Xtandi cost $50 a month, NOBODY would still be using Casodex....

Fairwind said...
Bicalutamide (Casodex) has been around a long time...Two newer drugs, Zytiga and Xtandi both work the same way but MUCH better and more effective...But these drugs are only used after a patient becomes hormone refractory and are seldom if ever used as a primary treatment mainly because insurance companies won't pay for that "experimental" use of these very expensive drugs..If Zytiga and Xtandi cost $50 a month, NOBODY would still be using Casodex....

Not to drift this thread further off course, but this is interesting, Pfizer is trying to gain approval for non-metastatic use of Xtandi. They see that as the holy grail, not to lower their pricing, but to make good their $14 B bet on the drug. I wouldn't look for the price to go down anytime soon!

From the article:
And besides, “as we've said all along, the real critical pivot point for that deal is the non-metastatic, the earlier stage prostate cancer,” CFO Frank D’Amelio added.

“We remain confident in our ability to get approval for those indications,” he said.

TA
Thanks much for all your insight. You're a walking encyclopedia and an amazingly generous guy. Very much appreciated!!🤗 God Bless!
Bob

Hi Bob, Can you possibly tell me who your oncologist is that uses Dr. Meyer's methodology? If not on the forum, here is my email address: [email protected].

I wouldn't mind a pair of eyes on my situation that is a little more comprehensive perhaps.

If you want to reach out to someone personally on the forum, can someone tell me how to do so? I don't see an option.

Thanks Redwing for remaining us the forum is not generally populated by the cured (who are outplaying golf..haha) and possible success stories surrounding specific therapies may not be heard.

Michael