Has anybody tried Zytiga re challenge after failed chemo?

[Amandaking]

We live in the UK and I’m hoping that the very knowledgable members of this site can advise us what to do next.

Diagnosed Oct 2014 Gleason 7 PSA 97 with lymph and bone mets. Aged 54 at diagnosis with no family history of Pca

Bicalutamide and Prostap then started on Zytiga and prednisalone (March 2015) which stopped March 2018 as PSA rising. Tested at Royal Marsden for BRCA Gene for Olaparib trial but negative so not eligible.

With the thought of Lu177 treatment in Germany my husband had a scan Ga68-PSMA showed PSMA avid results.)

Oncologist decided on 10 rounds of Doxy. PSA at start 75, after 2 rounds PSA 30 but rising with each subsequent round so have stopped after 6.

What next? Has anyone rechallenged with Zytiga?

Are there any indicators or tests to predict it may be effective and how long might it work for? In the USA you seem to have Foundation One for screening but I can’t find anything similar in the UK. Thank you for your help.

[Tall_Allen]

I wouldn't bother with the AR-V7 test (there are two that I know of) - just try taking it again and see if it does anything. Perhaps try it with dexamethasone instead of prednisone this time. The VISION trial of Lu-177-PSMA-617 is at University College Hospital in London.

[Amandaking in reply to Tall_Allen]

Thank you Tall Allen - if accepted on Vision Trial how soon are you told if you are getting Lu177? Very worried about the amount of time that all the options take whilst the disease worsens. As a matter of interest to others we did swap to dexamethasone with Zytiga which gave an extra 6 months of efficacy so well worth it.

[Tall_Allen in reply to Amandaking]

People on this site who have entered, got in as soon as they had a ga-68-PSMA-11 scan that demonstrated PSMA avidity. They randomize 2:1 after that.

[Chalkie42]

Diagnosed with Pca in 2005 After Radial open surgery PSA 4 and Pet scans revealed tumours in Lymph nodes. PSA started to rise after a year and in 2009 commenced ADT (Zolodex- Goserelin 10.8 implant 3 months) in 2015 this started to lose its race and cosadex (bicalutamide) added PSA down to 2 but stopped and Andronodon nilutamide introduced in April 2016. PSA up to 40 by end of the year and Taxatere (Docetaxei) Chemon started in Feb 2017 - after 7 infusions PSA plateaued at about 20. Started enzalutamide (Xtandi) in Oct 2017 PSA down to 10 by June 2018 but then on the rise - stopped when PSA was up to 125. Started Lut 177 trial (Peter Mac Cancer Centre - Melbourne AUSTRALIA in December 2018- PSA at 325 after 3 weeks but scans indicated the Lut177 was in the right places. PSA now down to 306 and no pain with second infusion today. Scans tomorrow. Up to 4 more infusions planned (every 6 weeks) Continue on Zolodex.

The trial is a phase 2 Trial compariing Cosadex (Chemo) v Lut 177.

I had a choice of Xtandi or Zytiga and I chose Xtandi - easier to schedule meds and no Steroids.

Good Luck

Chalkie from down under - now 72 7/12

[Amandaking in reply to Chalkie42]

Thanks for your help Chalkie42- we wish you well on the trial and hope you have time to keep us updated- sounds like you a a great fighter!

[vandy69]

Have rechallenged with Xtandi after 6 cycles of Docetaxel/Carboplatin chemo. Got me 4 more months of reduced PSA.

Best wishes. Never Give In.

Mark, Atlanta

[Amandaking in reply to vandy69]

Thank you vandy69-I went back through your posts and have seen other men get a response too - gives us hope thank you

[sedgley]

Hi Amanda. You mention the Royal Marsden and a test for the BRCA1 gene. Was this a biopsy or a simple blood test.

I ask because I am in the midst of probably having to have a second biopsy there very shortly- RM having failed to make any diagnosis at all from a 2016 rib biopsy taken at another hospital. Thanks.

[Amandaking in reply to sedgley]

Hello Sedgley- they used original 2014 prostate biopsy done at our local hospital and it came back negative after 5 weeks (which we thought was a long time) as this disease is ever evolving perhaps a more recent biopsy would be of more value? Good luck

[sedgley in reply to Amandaking]

Thanks Amanda. That fits in with where I am with RM at the moment.

[Amandaking in reply to sedgley]

I haven’t read your bio but just to let you know that they are also recruiting for Vision trial for Lu177 - sorry if that’s not applicable Thanks

[sedgley in reply to Amandaking]

Yes. I am on the list for a trial but first they need a successful biopsy as the 2016 tissue failed QC apparently.Dammit! That means a WBMRI this week and then probably a biopsy next week! Very frustrating with PSA rising rapidly…