Zytiga failed, starting Xtandi. What to expect for my dad.

I am super sad today. We got the news that Zytiga is failing and my dad is going to be switched to Xtandi. My dad has been feeling amazing and I’m so scared that the Xtandi wll change that. He was diagnosed with Stage IV, bone mets everywhere, Gleason 10, PSA 64 in November 2017. He had a great response to Zytiga and his PSA went from 64 to .2 then started raising to .6 to 2. Today-4wks later it is 3.5. He looks great and is feeling great so this is very difficult news for us. I am scared. He was doing so well and the Zytiga only worked for 7 short months. What should we expect? Any advice is very much appreciated

[dadeb]

That’s great he’s feeling so well. We got a 3 year run on Xtandi-but a lot weight gain. Not sure why, but they kept him on Prednisone the entire time. I’ve read here that it should be discontinued with Xtandi. ? Not sure. Good luck! Routing for you and your Dad to get many years. We’re in the second month of Earleda. Still hoping for Darolutimide.

[Hidden in reply to dadeb]

I would be so thankful for a 3yr run. Did he do Zytiga first? Was your Dad stage 4?

[dadeb in reply to Hidden]

Yes- Stage 4 and Zytiga first, but only got a few moths on it.

[Hidden in reply to dadeb]

Thank you for giving me hope.

[Grumpyswife]

Xtandi has it’s side effects as well and if it’s not effective you could do chem and try for the reset so many on here have spoken of.

There is also targeted immunotherapies as well as lut 177 trials starting. Treatment options are way better then in the past.

[Hidden in reply to Grumpyswife]

Thank you. How do I find out about trials?

[Blair77 in reply to Hidden]

Trials can be accessed through the NIH clinical trials website. Then you can search LU- 177 which will come up with trials that use LU -177 in Prostate cancer.

[Hidden in reply to Blair77]

Thank you!

[Kevinski65 in reply to Blair77]

I go to NIH. They pay for air travel back and forth

The medication is usually free. Meals are reimbursed, hotel they pay part of it...

[Blair77 in reply to Kevinski65]

You are getting LU 177 or something different? How is it working?

[Kevinski65 in reply to Blair77]

I am getting Xtandi. I'm 6 years out. They had a trial with Xtandi alone or Xtandi and Prostvac a vaccine. I got in the 'Xtandi alone' group. They added Xtandi to Lupron which I'm already taking. So 3 years on Xtandi and Lupron.

[MelaniePaul]

Hi Hopeseeker.

Oh that is sad news. I hope that Xtandi will work for you dad for longer than Zytiga did. I have heard, however, that when Zytiga fails Xtandi only works in 20 percent of cases. But of course you have to be hopeful and maybe it will be different for your dad. I wish you both good luck and strength!

Mel.

[Hidden in reply to MelaniePaul]

Thank you Mel

[huhnes]

I am wondering why he didn't do Casodex & eligard simultaneously. My understanding is that the first line of treatment (according to the doctor I saw at the Mayo Clinic).

[Hidden in reply to huhnes]

I will ask. Thank you

[Shumaf]

My dad had a 1 year run on Zytiga. Heis PSA got stable but mets spread to liver. He will soon receive a genetic testing results. According to the results, MO will either switch to Lynparza or if no genetic mutation, probably chemo again. I do not know why but MO does not consider Xtandi for now. May be because of liver involvement.

[Godschild62]

We were told that when Zytiga fails, going on Xtandi is not an option. They are very similar drugs and work very similar- testing showed that if one failed the other most likely will fail as well. It didn't matter which you started first, although doctors like Zytiga first as there are less side effects than Xtandi. Ask them about Radium 233.

[huhnes in reply to Godschild62]

My doctor said the exact same thing...

[Grumpyswife]

Going on Xtandi is an option in the US. However, it often fails but worth a try.

It is good to plan for what to do after Xtandi fails. Perhaps get the genetic testing done if he hasn’t had it yet. There was a company called Strata Oncology doing it free as part of a study. They needed a tumor tissue sample. You can study up on chemo and/or get into a clinical trial. Some of them require having chemo already.

[George79]

When Zytiga failed after 18 months wend on xandi. Constant nausea and no benefits now on chemo. Worth a try.

[Hidden in reply to George79]

I’m sorry it didn’t work for you. I hope the chemo works!

[Kevinski65]

Was Zytiga taken with Lupron? I'm not a doctor but there are ways to resensitize the cells to Zytiga or Xtandi. One is to get a few rounds of taxetere under his belt. There is another substance called forskolin. Only take it for 2 weeks. This you can get over the counter. You should have gaviscon antacid in case it bothers the stomach actually tagamet slows prostate cancer down so this may be good to do instead of gaviscon. Forskolin will resensitize the cancer cells to Zytiga or Lupron. Also try to get him on metformin if u can. You can also order Zyflamend FOR PROSTATE. You can order online from lucky vitamin at Amazon. I'm not giving medical advice. I am saying what do u have to lose? If you decide to do this let me know what happens. I've done all this and more and I'm 6 years out on Lupron and Xtandi. Good luck!

[Hidden in reply to Kevinski65]

Yes he was taking Zytiga, Lupron and prednisone. Thank you for all of this info. I haven’t heard of most of these things. I appreciate it and I will look into these options!

[leo_mo in reply to Kevinski65]

Hello! My father is taking abiraterone (Zytiga) and PSA is rising now... Could You give more information about Forskolin for re-sensitizing cancer cells to Zytiga?

[Kevinski65 in reply to leo_mo]

Google this, I read about it, I hav

[PLASTICMAN]

Am 78. Have been fighting this PCa for over 10 years now. Was on Eligard (lupron) every 3 months but when that was not enough they added Xtandi (enzalutamide) to the treatment. PSA went down to 2 approximately but then, after about 4 months, started increasing rapidly to 7.05. Was taken off Xtandi and put on Docetaxel, Prednisone, and Denosumab (Xtega). Did 4 sessions and PSA went down from 7.05 to 6.95. Amazing right? I refused more infusions of docetaxel as I'm feeling really lousy....weak, fatigued, queasy, mets in hip and lower spine beginning to ache (am taking Diclofenac 75 at the moment). Reducing Prednisone a bit to see if that has something to do with how I feel.

Next step? doing bone scan and MRI plus blood test to see where we go from now. I'm inclined to try Zytiga (abiraterone) with the Lupron/Eligard as I've noticed that this works well for some patients but not for others, same as Xtandi. If that doesn't work, maybe will try Xofigo (radium).

Onc should look at levels of alkaline phosphatase as in advanced stages of this disease PSA may not move around so much and may not be such a good measure of cancer activity.

[Hidden in reply to PLASTICMAN]

His alp levels started rising as well. His alp initially was in the 2000’s and then was brought down all the way to 202 and last test was up to 330.

[Daddysdaughter]

Hi, my father is a Gleason 9 he has failed all treatments Xtandi, chemo, PSA has been going up now 150+ finally we had made a decision to go into trial land. I did a lot of reading on lutetium 177 and we are lucky enough to get him on a trial. I wouldn’t be to afraid, he may respond just fine to it. Keep positive and don’t dwell on every symptom. I found that worked with my father. Good luck keep posting! Prayers to you and you pops!

[Hidden in reply to Daddysdaughter]

Thank you! Please keep me posted on the trial. I am sending you and your dad lots of prayers for an amazing result!

[Daddysdaughter]

Hi, my father is a Gleason 9 he has failed all treatments Xtandi, chemo, PSA has been going up now 150+ finally we had made a decision to go into trial land. I did a lot of reading on lutetium 177 and we are lucky enough to get him on a trial. I wouldn’t be to afraid, he may respond just fine to it. Keep positive and don’t dwell on every symptom. I found that worked with my father. Good luck keep posting! Prayers to you and you pops!