Future more immediate

[joancarles]

I have read some comments that talk about a more potent medicameto than Zytiga in the near future. My Oncologist told me that this is when a new powerful drug falls. Do you have any clue what is it about? And for when is it planned?

[Lombardi24]

Not sure what will replace Zytiga. That's one of the big androgen blockade meds.

[Tall_Allen]

There are several new hormonal therapies in the pipeline. Darolutamide just tested well for NON-metastatic CRPC, so I'd guess it will become available for that indication early next year (joining Erleada (apalutamide) and Xtandi (enzalutamide)). The PATCH trial of transcutaneous estradiol is expected to have primary completion in 2021, but is available now.

[Peterd110 in reply to Tall_Allen]

Was it tested at all for metastatic disease?

[Tall_Allen in reply to Peterd110]

The estradiol patch? Yes, it was tested in Phase 2 clinical trials in men who were stage T3, N1 or M1 or recurrent with high PSA or short PSADT. Based on that success and safety, they expanded it to a Phase 3 trial.

meetinglibrary.asco.org/rec...

[GP24 in reply to Tall_Allen]

I have read that you can also use Estradiol gel instead:

healthunlocked.com/advanced...

[Tall_Allen in reply to GP24]

They tried to do an arm of PATCH with a gel. They couldn’t get enough men to sign up for it.

[Break60 in reply to Tall_Allen]

TA

Is this the same patch I’ve used to stop hot flushes while on ADT3? Presumably not.

Is the patch in lieu of xtandi, Zytiga etc . or after they’ve failed?

Bob

[Tall_Allen in reply to Break60]

It's used to stop hot flashes as well.

[Break60 in reply to Tall_Allen]

Yes but are they now saying the patches can be used in lieu of adt?

[Tall_Allen in reply to Break60]

Yes, that is the hope. They are comparing it to Goserelin in the randomized trial.

clinicaltrials.gov/ct2/show...

[Fairwind]

No matter what they do with hormones, sooner or later PC becomes immune to all forms of hormone therapy...When Zytiga and Xtandi stop working, you have pretty much reached the end of the line with ADT..

[Hidden in reply to Fairwind]

Then what? Chemo as a last resort?

[Patrick-Turner in reply to Fairwind]

It may seem like all existing known forms of hormone manipulation in men with Pca may be overcome by the Pca ability to block, ignore or avade the action of such chemicals. Then perhaps out bodies try to stop drugs working. But the fact is that research is driven by the huge piles of money to be made in adding to the collection bottles of stuff which can be tried one after the other.

I came to the end of Zytiga working, and Medicare rules in Australia outlaw anyone who tries to switch from abiraterone to enzalutamide. So I didn;t get to try enza, and I was offered Docetaxel, chemo. I had 5 infusions, Psa flared from 12 to 27, then never fell below 26, and then went to 45, 36, 42, and so it was declared a failure, so I will be starting Lu177 on Nov 8. Otherwise there was nothing except switching to cabazitaxel or carboplatin, with worse side effects, and treatment becomes experimental with no sure outcome.

But last week, I cycled 275km, and today I did 70km and the only problem I had was trying toget used to new Brookes leather saddle after the old one broke. It was super comfortable before it broke. The new Brookes has The Stiffest Hard leather I have even known; I have cycled a total of 240,000km in my life so far, and maybe I have worn out about 6 Brookes saddles; I have managed to break every single part of them. But all other Gee Wizz Carbon fibre or plastic crap saddles are impossible for me to ride on. I have tried so many......

I'll be mowing the grass tomorrow a.m, and doing craft work in shed.

People would not think there's much wrong with me, but the scans show a terrible short future soon if I don't do something, and I have not heard / read enough bad reports about Lu177 to ignore it.

I hope the expensive Xmas present to myself is a lower Psa.

Medicare does not cover Lu177, so its $40,000 for 4 infusions. But I think I'll have less side effects than if I continue chemo, and get more Pca reduction, and get more extension of lifetime. I could return to chemo later, and doc says the Lu177 and chemo will probably make Pca respond to abiraterone or enzalutamide. The war is not over yet.

I had thought of asking Germaine Greer togive me a little of her bone marrow for a transplant, because I reckon her DNA would be super-hyper anti bad men's genes, and the Pca just would not know what hit it. But the side effects might be less than other female hormones. I do not wanna grow breasts to beat Pca.

I don't have any hot flushes despite being a testosterone free zone for last 8 years.

I did get them for first year of ADT, but then I kept on cycling, and HFs just faded away. And last year at this time I was faster on my bike than all the other blokes of my age in a large cycle group. They wondered "HTF can a castrated bloke with cancer beat us, and with a pair of new replacement knees? " But I could not keep cycling with them because abiraterone side effects were an upset heart rate, and allergy to cycling in summer with many days over 30C by 10am. So I have mainly cycled alone and any time in day in all winter, ( no slow and ice here ), and in summer I am on bike at 6am, and back home by 10, and there's no point riding faster than other ppl, and I still get all the health benefits. I found that in cycling groups and in other single activity groups, those taking part never are friendly away from the group. I am not at all needy of groups of ppl who don't have sharable interests outside the group, and lets face it, blokes with cancer are not taken seriously, kind of avoided because blokes are reminded of something negative, and because they think you are temporary, and they just don't know how to handle anyone with cancer. In the cycle group there were often about 30% ladies between 18 and and 55, but none could keep up to an old slow man like me. Most were "taken", or just wierd, more than many of the blokes. I like being here because Pca is what we have in common, and I don't mind sharing the experience, and maybe it enables others to come to terms with their ailment.

Patrick Turner

[charlesmeyers1964]

some people have been taking lu177 the problem it isn't offered in a lot of cities in the usa. so there might be good results in a particular drug but if its not where u live and the cost isn't acceptable then options u must look at. the lupron/eliguard shot is 3,000 but ss pays for it. the PROVENGE treatment is 72,000 each 3 times but again ss pays for it. zytiga is 10390 per month so again its all about finding a foundation to pay your share unless your a millionaire

charlie

[joancarles]

Thank you very much for your responses. I will investigate in Spain.