Have had AR-V7 test which was negative which is good. Positive would predict almost certain failure.
Are there known statistics that might predict chances of success or failure of switching to Zytiga once Xtandi has failed,,,and AR-V7 is negative?
Medicare part “D” donut hole plus 2 or 3 months before Zytiga effectiveness might be determined could be a 5,000 dollar hit, only to possibly find that Zytiga was of no value and a waste of resources and additional side effects.
Also was curious if any available information of current and upcoming Xtandi successors may work even though Xtandi has failed,,Alpa and Daro.
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Sxrxrnr1
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Perhaps you should consider chemo with cabazitaxel instead of starting zytiga. Sometimes chemo may sensitize the cancer to enzalutamide or abiraterone.
Underwent 6 session Taxotere while on Xtandi. Hit PSA nadir of 3 from peak of 18. Xtandi mono had taken me from PSA peak the day I started of 374 and down to 10 in 4 or so months before adding Taxotere at PSA 18. Still on Xtandi, when chemo was done and PSA began its relentless climb to now 55 after 8 months or so. Added Lupron at about 12,,,never slowed at all, indication of immediate failure.
If Lupron is doing anything at all,,,,in my mind it is only to the relative harmless PCa cells that are not hormone resistant,,,and there of course is no proof even of that. So why am I still on it,,,,even my MO’s will/can not answer that except to tell me I should stay on it as perhaps it is slowing progression?????
Meanwhile my fasting glucose has risen while on Lupron from about 80 to 160 and side effects of T at 9 are abominable...so for a remote guesswork possible marginal benefit from Lupron,,,,I am tearing apart and compromising all the good health, cardio, QOL, bone stability, mental acuity that I have always enjoyed. So why am I on Lupron,,,,I guess it’s SOC for the past 40 years to be so,,,even when obviously failing.
Does anyone know of any studies anywhere that ADT leads to any overall survival benefit? I am aware of beneficial stats on Zytiga, but have never seen any studies on ADT only,,,not just anecdotal reports,,,where ADT in its various guises actually extends overall life expectancy. My suspicion has always been it could decrease overall survival while postponing PCa specific mortality.
I had all these and many other such unanswered questions 14 years ago when first dx’d. Therefore choosing not to submit to any therapy at that time.
Always has been amazing to me this whole subject to treat or not to treat is seldom if ever discussed in polite company. But treatment methods are subject to confounding endless debate.
I have applied for consideration in two competing LU 177 trials at two different university centers in Calyfornua. One with PMSA only, the other with the addition of Keytruda
The Lu/PMSA trial, one out of three are randomly selected to no LU 177 and given SOC only. How that works I have no idea, but when one is down to the short straws of failing of various ADT options and a failed Taxotere program,,,,SOC appears at this time a poor option with very little going for it. Nevertheless not chosen to participate in any arm as of yet.
The Keytruda/Lu trial I have not been selected for,,,the most recent rejection was that I was told that my bone mets were sufficient, had met all required criteria, had no exclusions. However my March 2019 CT Scan showed my lymph mets were not large enough.
Was requested to do another CT scan to check out mets again, telephone conversation with MO to go over results were though lymph mets had increased again in size,,,still not big enough. Rejected again.
MO knows that I currently am on only failed Lupron, have failed Xtandi, have failed Taxotere, cannot try Radium 223 (Xofigo) as firm disqualification for future Lu 177 trial inclusion and yet tells me to maintain SOC until possible future consideration,,,with only options being cabaztaxal or Zytiga which having failed Xtandi is likely no option at all,,,,,hence my original posting of this thread. All this with a PSADT of less than one month.
Getting a bit overwhelmingly complicated. About to have a close looksee at BAT or ceasing failed Lupron which currently is very bothersome and likely of very small benefit if any with a massive penalty overhead in QOL and detriment to my health of other bodily functions and systems. Again T on only 1/2 monthly dose of Lupron is firmly ensconced at 9 give or take.
I read of all these patients in trials, and ask how are they gotten into. Does it depend upon treating Physicians or is it the luck of the draw?
Statistics for what they are worth, suggest that OS at 5 years post beginning of Crpc mets is 30 percent survival. Currently 2 years into this swamp,,so am somewhere close to the mean for OS,,,at least with past more limited systemic therapy,,,,which to date with exception of failed Xtandi is where I am.
Truly not concerned, but certainly damn interesting.
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Zytiga failed, starting Xtandi. What to expect for my dad. 
What comes after Zytiga and Xtandi have failed?
Xtandi monotherapy is very effective
Update on \"Zytiga failed, Xtandi next\" from 8 days ago
