Abiraterone added to Lupron

[ken12491]

I'm seeing my MO later toady. Been off Lupon for 1.5 years wit PSA rising steadily. He said 3 months ago that lupron will be started again soon. Lupron keep my PSA level undetectable for one year. I am not castration resisdent at this point and responded well to it for the full year I was on Lupron.

Question - he also he might also suggest Abriraterone to the lupron as an added benefit to me. Is Abiraterone ( Zytiga ) a pill? and did it that the place of docetaxel based on the stampede trial?

Does medicare cover Abiraterone?

Did the new research ( stampede) suggest that Abriraterone is better than docetaxel?

Are the side effect less of an impact than the docetaxel?

Thanks...

[LearnAll]

Abirateron is a tablet....I think medicare covers it...Abiraterone is as effective as Docetaxyl...Price of Abiraterone used to be 9000 dollar in USA until a year ago but now it is 2400 dollar for a month. In India, price is 150 dollars.

[Fairwind]

Abiraterone (Zytiga) is not chemo. it's a form of ADT, it prevents testosterone production better than anything else including castration.. Medicare should cover 80% of it..You take it (pills) with prednisone. Very moderate side-effects if any....The chemo comes when the ADT stops working....

[ken12491 in reply to Fairwind]

Thanks, Fairway....so it s possible for the MO to put me on both Lupron and Zytiga at the same time?

[gcraft6 in reply to ken12491]

i've been on both for 3 1/2 yrs

[Tall_Allen]

Abiraterone (4 -250 mg pills) or docetaxel are approved for 2 situations:

1. Newly diagnosed, metastatic

2. metastatic, castration-resistant PC

You are recurrent after RP and SRT, so you don't fall into either category. Sometimes, insurance/Medicare will approve it anyway. There is a clinical trial for recurrent men that randomizes them to degarelix±abiraterone±apalutamide. Check study locations for one near you:

clinicaltrials.gov/ct2/show...

In the newly diagnosed situation, the degree of side effects was similar for docetaxel and abiraterone, although they were different in kind. The efficacy was the same:

pcnrv.blogspot.com/2017/06/...

In the CHAARTED study, docetaxel extended life only when there were multiple metastases. My opinion is that because a cycle of docetaxel is completed after 15 weeks, you can get both it and abiraterone sooner than if you start with abiraterone. Side effects and efficacy are better for both drugs if started earlier.

[ken12491 in reply to Tall_Allen]

Thanks, Allen - but since I m not castration-resistant at this point Lupron would be the most likely route till it no longer works? He did tell me on my last visit some men have stayed on it for years because they never become castration-resistant but this was not the norm. Also said ' adt ' vacations could be taken along the way.

If Abiraterone is better then Lupron would a dr. consider it alone without the Lupron?

[Tall_Allen in reply to ken12491]

I have no idea if hitting it hard as in that clinical trial is better than Lupron or Firmagon only - that's why they are doing that trial. I also have no idea if abiraterone monotherapy can replace Lupron for recurrent men (there was only a small, retrospective study in men who were already detectably metastatic (on a bone scan/CT) and castration resistant). I also have no idea if Lupron or Casodex is better for early ADT in recurrent men. Intermittent ADT is certainly an option too.

[NPfisherman]

Hi Ken,

I reviewed your information and you had IMRT along with Lupron--I believe you stated salvage radiation. You also had RP. I think you should look at getting a Ga68 PSMA scan--pinpoint where the recurrence is, and if in pelvic area--get Adjuvant--total pelvic radiation treatment while on ADT--can be Lupron only. This may get you the cure if it is still localized.

STAMPEDE showed a benefit with Zytiga and ADT in low disease burden patients. The downside of doing chemo first is that there are concerns regarding chemo effecting other treatments--recently in Checkmate 650--25% of chemo naïve men had a response to treatment versus 10% on patients that had chemo previously.

I have chosen to delay chemo for as long as possible. My MO has people that have been on Zytiga and Lupron for over 7 years and still no disease progression. IMHO, get the scan and see if still local, and then decide.

Best of luck,

Don Pescado

[Nachas613]

May be worthwhile getting an ARV7 test

oncotypeiq.com/en-US/announ...

[Collarpurple]

Hope you have went thru donut hole first

Medicare does cover husband cost is 364.00

A month. We found a open grant that we qualify for it did cover donut hole So that helped a lot

[Collarpurple]

Also husband is on lupron tooHot flashes and tired in afternoon

But nothing major

[dsamuel1 in reply to Collarpurple]

I use Paxil (paroxitine) at 20 mg to almost totally eliminate the hot flashes. My urologist prescribed it.

[Collarpurple in reply to dsamuel1]

Thanks for info

[Hidden]

After surgery in 2008 (PSA recurred) and 38 rounds of radiation in 2009 (PSA recurred), I was treated with Lupron, Casodex, Avodart and Cabergoline in 2011. This ADT4 kept the PSA undetectable for one year, then PSA recurred. I switched the antiandrogen from Casodex to Nilutamide and returned to undetectable PSA. In 2014, I had treatment with Provenge. In 2016, I stopped all treatment and PSA remains undetectable to date. Knock on wood....

[toml77 in reply to Hidden]

any side effects from the provenge?

[cmeek1 in reply to toml77]

I had no side effects from the provenge. I really believe that the immunotherapy worked for me. I have been off all PC drugs for 4 years with 0.006 PSA and T around 80.

[Rsdutcher7]

Lupron stops production of testosterone from testies where 90% comes from. Abirateorone (Zytiga) cuts of the 10% that comes from adrenal glands. That’s why you HAVE to take prednisone with it or your adrenals wouldn’t function. So it gives 100% NO testosterone with them combined. Nothing to feed normal prostate cancer. Can help it mutate to NED prostate cancer though eventually.