Xtandi

[Stelle]

I have been on Xtandi for two months and PSA is now down to .59 and I feel much better than when I was on Lupron and Casodex. I have read the literature and it seems that Xtandi may work from three to 22 months. They don't ever seem to tell you what the standard deviation is. Has anyone on this forum been taking it for longer than 22 months?

[Stelle]

Thank you for the hope!

[ctarleton]

You might want to clarify what you mean when you talk about how Xtandi may "work" from 3 to 22 months. Was that in terms of time to PSA progression, radiographic progression, usage of subsequent chemo, overall survival, etc.?

The major trials associated with approval of Xtandi in the USA were the PREVAIL, AFFIRM, and TERRAIN clinical trials. Each trial involved different types of patients, involving either placebo or before/after docetaxel or compared to casodex, and measured several trial end points and interim analysis points.

(The statistics they use in clinical trials more often involve "median" numbers (e.g. the time at which 1/2 of the participants have had something specific happen, and 1/2 of the participants have not yet had that same thing happen yet.), along with 95% confidence intervals on either side, and "hazard ratios", rather than averages and standard deviations.) If you Google some of those clinical trials mentioned above, you can just "look at" some of the Kaplan–Meier Estimates charts and get a "feel" for how things went in the beginning, middle, and end of clinical trials for the patient participants both before and after the graphed numbers crossed the 50% "median" line. )

In your case, with a prior orchiectomy, there could be different factors involved.

In my individual case, after an initial diagnosis of metastatic to bones/lymph nodes and a PSA of 5,006 at age 65, I responded well to the treatments of Lupron, Zometa, for a PSA nadir of 1.0, developed mCRPC and was treated with Provenge, added Xtandi to the mix at the 3 year point with a PSA of 95.0, and have been on Xtandi for 16 months now. Xtandi nadir PSA was 1.2, and current Xtandi PSA is 1.7. (No surgeries nor radiation treatments, to date.)

My energy levels were trending down on Lupron anyway. Adding Xtandi has put me into the mild background fatigue range much of the time. "I'll take it", as a 4 year and 4 month survivor, so far.

Charles

[EdBar]

I've been taking Xtandi since July 2015, PSA still undetectable <0.006, scans clear, Alka Phos normal, it is part of triple HT that I remain on. Side effects are no picnic and seem to escalate over time, but it beats the alternative. BTW I've also had chemo per CHAARTED and radiation to prostate and several nodes.

One More Cast...

Ed

[David20451]

Taking Xtandi since 4/14. PSA undetectable since 7/14.

[Caring7]

My husband was on it for more than 2 years and did pretty well. He's off now and we still have about a 1/2 bottle of pills. He's trying Zytiga - fingers crossed.

We have always reached for these guidelines too but the truth is that every man is different, responds differently in specifics. The case studies are the best way to know how things work "overall" and you're going to be somewhere in there. Keep a healthy positive attitude -- it does make a difference.