Casodex after failing Xtandi and Lupron

[Sxrxrnr1]

G9 cancer, diagnosis 2005 with PSA 5.5 then.

No treatment of any type,,no RP, RT, ADT for next 13 years. PSA by early(March) 2017 had climbed to 70, MRI and Pet CT were clean.

September PSA had jumped to 260 MRI scan was normal showing contained tumor in Prostate. However Pet CT showed Mets of lymph nodes, pelvis and a couple of Ribs.

Went on Xtandi monotherapy, the day I started PSA was at 374. 6 weeks later was at just over 10. Slowly began to rise to 17. Signed on to 6 sessions of Taxotere. PSA dropped to 3 after final infusion

Then began to climb again to 8 over next couple of months while still on Xtandi mono. Signed on for Lupron 1/2 normal monthly dose. “T” dropped from 900 to 16... after 3 lupron 1/2 doses, “T” still about 17, but PSA has risen to 25. So was 3 at end of Taxotere in November 2018 and now at 25. I dropped Xtandi Dec 2018 so as not get clobbered by 5,000 dollar donut hole in January 2019,,,and it was apparent that it had failed,,,as has Lupron, but still on it.

Have not yet tried Zytiga as will be very costly,,,,and as having failed Xtandi, possibilitiy strong will not work anyhow.

I have asked my MO to prescribe a AR-V7 test to find if I am positive. If not I will likely try Zytiga. Just do not wish to waste 5k if I am positive.

With this background, this is my question,,,finally:

Having failed Lupron and Xtandi, and not yet having AR-V7 result, does Casodex give a wit about AR-V7 variant as does Xtandi and Zytiga?. I do happen to have a 90 supply of it, and am considering taking 150 mg daily with my 1/2 dose of Lupron each month. I suspect it will deal well with the very small 15 or so “T number that remains after lupron, likely from adrenals, but would it do anything for me in destroying the cancer receptors from manufacturing their own “T” good supply.

As an aside, I am attempting to be considered for Lu-177/Opdivo upcoming trial at UCSF or Lu-177/PMSA trial at Stanford. UCSF trial not yet recruiting. I do have an appointment with MO in charge in about 10 days.

I one finger peck this out on my iPad, excuse any typos

[Crabcrushe]

I just read about decitabine...?

Nous Defions

Crabcrusher

[Magnus1964]

Each ATD drug works in a different manner. So yes, go for it.

[Sxrxrnr]

Excellent points on repurposed drugs, etc. also in particular using only 50 mg daily Casodex. I was aware, but had not considered before you mentioned it, that 150 mg daily was for those on Casodex monotherapy with no Lupron injections.

Point of curiosity. Would 50 mg daily have less side effects from Casodex verses 150 mg daily?

I am aware that lower than recommended daily doses of Xtandi, lessens fatigue side effects and possibly others.

As I noted in original posting, I said was taking only 1/2 normal monthly dose of Lupron. As “T” has remained at castrate(about17), I see no benefit to a full normal dose. However is there any benefit except possibly saving insurance some money. Would there be any difference at all in side effects, I am assuming that all SE’s are an absence of “T” and not from the Lupron medication itself?

[tango65]

It seems the AR-V7 splice variant confers resistant to bicalutamide as well as enzalutamide.

ncbi.nlm.nih.gov/pmc/articl...

Perhaps you could consider the trials at Davis of enza plus niclosamide or abi plus niclosamide:

clinicaltrials.gov/ct2/resu...

Other avenue of tratment could be the trials of Lu 177 PSMA if you qualify:

clinicaltrials.gov/ct2/resu...

[Godblessus]

If you are in a position to pay for treatment, I just returned from Homburg Germany where I received PMSA lutetium/actinium therapy for metastatic Prostate cancer. It is not a cure but he has great success with remission, and is the new standard of care for ADT resistant prostate cancer in Germany. Dr Ezziddin is one of the pioneers, and one of the two to use tandem therapy that I know of, the clinic is excellent, the staff competent. The mostly speak English

Dr Ezziddin:

youtu.be/LrDtPz0G_ZI(Not working as expected?)

Conceptualization:

youtu.be/GRRmX5eTa8s(Not working as expected?)

If you are interested please contact Mrs Sutter at the university and you may tell her Steve from Texas referred you :

[e-mail]

Mrs. Kerstin Sutter

Universitätsklinikum des Saarlandes

Klinik für Nuklearmedizin

Case Management

Koordinatorin der Tumortherapien

Gebäude 50

66421 Homburg, Deutschland

[phone]