Just wondering if anyone else has seen there testosterone go up above castrate level after starting xtandi. I have been on firmagon and eligard for 2 years and T always stayed around 30. After starting xtandi 3 months ago due to developing castration resistance, my T has risen to 63 which is above castrate level. Not sure if it's worth staying on 3 month eligard shot if it's not keeping me below castrate level. Xtandi has been very good at lowering Psa, now undetectable
Has anyone seen testosterone rise on ... - Advanced Prostate...
Have thought about it, but for some reason my testosterone is difficult to get low. My urologist says he has 4 guys like me that don't go as low as they should on firmagon or eligard. He made the comment he wasn't even sure if he could get me lower than 30 - 35 if he castrated me. I haven't been in to see him yet since my T Jumped up to 63
My testosterone for the past 4 years has been < 20 while on Lupron and Xtandi. A few days ago it was 29.5. My PSA was still 0.02 which NIH says is essentially 0. I get a Lupron shot every 4 months. At the time of my NIH visit I had just received my Lupron shot. They gave me a CAT scan and a bone scan which showed nothing new. Can your testosterone begin to rise on Lupron? If so would it be advisable to switch to degarilix?
All androgen receptors are not necessarely blocked by the anti androgens, the cancer may be receiving some testosterone. I believe that is the reason that they use 150 mg of Casodex insteadd of 50 when it is used without ADT. There is some evidence that there is better control of the cancer if the testosterone is below 20. Perhaps this is more important in Castration resistant PC because of the over expression of the AR.
No, it was working but the doctors I consulted decided to stop it. Apparently when Casodex stops working it is because of the AR-V7 splice variant, the same one that stops enza and abi. They think that casodex could make these drugs less effective. I can not have chemo, so they decided to let the PSA increase, get the Ga 68 PSMA PET/CT and if there are metastases treat them with SBRT or with Lu 177 PSMA if it is possible.
I am currently not aware of a study that determined that bicalutamide causes AR-V7 mutations. In this study:
they showed the increase of AR-V7 mutations depending on the number of treatments in the CRPC situation.
I refer to this information:
These studies could not determine a difference if antiandrogenes were used before Abiraterone. This review:
states: "Although insufficient evidence currently exists indicating that the prior use of antiandrogens compromises the efficacy of abiraterone or enzalutamide, ..."
This is one article relating bicalutamide resistant and AR-V7 splice variant: