Xtandi appears to be ineffective

[GoNapoli]

Hello all! Well it looks like Xtandi is not working to lower PSA, we are 5 weeks in and PSA has been climbing rapidly, Alkaline Phos been holding steady at 90. Dr. has scans ordered and may have to start Cabazetaxel soon and probably last two Provenge treatments will be cancelled. I hear Cabazetaxel has a little less side effects than Docetaxel, what is your experiences out there? my Dad tolerated it well but no having taste made him so depressed. He loves to cook and loves to taste his food. PSA is up to 160. One other question for the group does Eligard has the same ingredients as Lupron? Originally my Dad had a Lupron shot and Bicalmutide (1month) day after diagnosis, (May2020) which brought PSA from 680 to 10 immediately like within a month, my Dad was asking because he is on Eligard now, but I believe it is the same and he has just become resistant.

[LearnAll]

Eligard has the same ingredient in it as lupron...and it is called LEUPROLIDE. Eligard is a brand name from one company whereas lupron is abrand name of a different company. Eligard is given subcutaneously in abdominal fatthy tissue. Lupron is given in muscles of hips.

As for mechanism of action, both Eligard and Lupron work the same way..that is they act on Hypothalamus-Pituitary-Testicle Axis resulting in testosterone depletion in blood.

Once androgen sensitive prostate cancer cells do not get testosterone.. they wilt away and DIE.

Resistance is defined as continuous rise in PSA even if testosterone is below 20.

[Brackenridge]

I’m definitely NOT an expert but I think the many who are on this site will tell you that 5 weeks is too short of a time to judge the efficacy of XTandi and that many times the PSA does indeed rise after commencement of the drug - cancer cells dying many times emit PSA. The scans should tell you more info than the PSA at this point I think. My Dad was on XTandi effectively for 2.5 years with the major side effect of fatigue. He is currently on 1/2 doses of Docetaxel with intermittent pauses because of ureter stent replacement and flare ups of his MS. Other than exhaustion and edginess from the accompanying steroid he is tolerating it okay. Time will tell its effectiveness but all my digits are crossed it works for a while longer than the Zytiga which for him had worse side effects. Good luck and fond wishes to you both.

[dhccpa in reply to Brackenridge]

Why did Xtandi stop working? Did the doc determine the specific cause?

[Brackenridge in reply to dhccpa]

I don’t know the specific science reason why the Xtandi stopped working but I do know cancer is pretty smart and also doesn’t know that it’s bad for our bodies so it’s cells keep working hard to survive and multiply - and therefore continues to find “work arounds” around the poisons we send to kill it.

[dhccpa in reply to Brackenridge]

Fair enough.

[Tall_Allen]

There is a Lupron shortage, but Eligard is the same chemical. As long as it's keeping his testosterone low, it is working. The scans will tell you if the Xtandi is failing.

He might try ice chips in his mouth during the infusions to prevent dysgeusia.