Xtandi, how long could it take to work?

[JuanVV]

My husband has taken Xtandi for three months now after becoming castrate resistant to Firmagon. His Psa with Xtandi went down from 37 to 31 the first month, then went up 2nd month to 54 because he stopped taking it for a few days because he couldn't manage side effects -rib pain- (he has mets in bones). The third month he took full dosage every day and it has gone up slightly to 57. Not sure if it's too soon to see if it's working, his tosterone went down slightly. I wonder how often everyone is having Psa tests? And if Psa can go up and then down taking Xtandi? Thanks for all your support it means a lot to us. Oh and by the way his options are limited because of his heart condition fibrial atrilation, he takes sotalol which interacts negatively with most treatments

[LearnAll]

PSA up and down by a few points does not indicate a trend. And trend is what really matters. So, can not make any conclusion at this point.

I get PSA done every 30 days and chart it on a graph paper with little notes about medicines, food, supplements etc.

[JuanVV in reply to LearnAll]

Thanks so much good idea to chart it all!

[whatsinaname in reply to JuanVV]

I just keep my blood test results serially (the latest on top). I have been asked to take my PSA tests every 15 days (now that I have started Lu-177).

[JuanVV in reply to whatsinaname]

Thanks! Interesting they consider 15 days. Wish you a lot of luck with Lu-177, how much time have you been on it?

[whatsinaname in reply to JuanVV]

My first infusion was on the 23rd of April. The second one is on the 2nd of July.

Thank you very much for your good wishes. Cheers !!

[monte1111 in reply to whatsinaname]

Next Tuesday. Let's hope for the big turn around!

[whatsinaname in reply to monte1111]

Thanks a ton, monte1111.

I too am hoping that the treatment results in a turn around.

For the "turn around" to take place, the following should happen :-

1) My PSA should finally begin falling 2) My mets should decrease in

both size and qty 3) The pain that I am getting now should lessen

considerably.

Odds don't favor this happening, but lets hope for the best

I will know for sure within 45 days of the infusion or around the

middle of August, 2019.

Thanks again, monte1111, you have been a very good friend. Cheers !!

[Magnus1964]

He will have to take xtandi with no breaks for a while before a trend can be found.

If xtandi is giving him problems maybe he could switch to another ADT drug.

[JuanVV in reply to Magnus1964]

Thanks very much.

[JuanVV]

Thanks great to know, hadn't heard about the AR-V7 test.

[JuanVV]

Thanks!

[Tall_Allen]

What are his bone scans showing?

[JuanVV]

That he has several points in the ribs and two in lower spine area that are suspicious of being mets, it showed up in the

bone scintigraphy.

[AZjame]

Here's a link to NEJM article about AR-V7 and xtandi/zytiga resistance:

nejm.org/doi/full/10.1056/N...

[JuanVV in reply to AZjame]

That's super thanks so much!

[CalBear74 in reply to AZjame]

Good article in the NEJM. Thanks for posting.

[Grumpyswife]

If Xtandi fails there is a 15-30% chance Zytiga will work. Our doc said 30 as he must be more positive and he said it’s worth a try.

[JuanVV]

Thanks mjbach so much, we'll be seeing doc next week, I'll talk to him about Zytiga. But according to what I've read and advice from all the wonderful people here i think it is too soon, nevertheless it's good to be a step ahead just in case.