Zytiga after taxotere chemo? Help understanding

[ellie2211]

Hi everyone,

My father has had 10 rounds of chemo (his last one is this week), he went from a psa of 2000 to his current psa of 0.2, we started this journey in December last year and he has been on lupron since pretty early on (had some kidney issues and had it delayed the first month) he also was on casodex in the beginning.

His oncologist has mentioned starting him on zytiga after his infusions are over. I have read that zytiga is usually given further along and im worried about what the implications are. And if there are less treatment options after it?

Thank you for any feedback about the drug/treatment plan

[gleason9guy]

My understanding is that there is a school of thought on this that the Zytiga can and should be given earlier during treatment. I'm not sure what you mean by treatment implications. From the small amount of information that you've shared about this case, it sounds to me like the oncologist is wanting to keep a positive momentum going for your dad. I wish you and your family the very best of luck in this journey!

[ellie2211 in reply to gleason9guy]

Thank you, I wish the same for you!

[NPfisherman]

Hi Ellie,

Studies so far have shown a clear survival benefit from early Zytiga--see below:

urotoday.com/conference-hig...

Currently, the PEACE-1 trial is going on comparing 4 different scenarios including early docetaxol followed by abiraterone acetate or Zytiga, prednisone + SOC-- I believe this will show the best benefit, especially in high risk disease...we shall see as this study should have some information coming out within a year...

In the meantime, celebrate the good results...enjoy life....do something fun with Dad....

All the best,

Don Pescado

[ellie2211 in reply to NPfisherman]

Thank you!

[Tall_Allen]

Don't worry about treatment options later - focus on what can be done now. Treatments improve survival more if used earlier. Zytiga is approved for early use (mHSPC) and for later use (mCRPC)..

[Flash64]

Hi ellie2211

I went on to Zytiga 3 months after completing 6 rounds of Docetaxel. There is little literature supporting this approach as it is quite "new", but my oncologist mentioned that there was an abstract at ASCO 2019 that indicated that this approach is showing long term benefits. My PSA when I started Zytiga (in January 2018) was 0.38, but since October 2018 it has been undetectable. Good luck!

[ellie2211 in reply to Flash64]

Thank you, good luck to you too! That's great

[Hidden]

First, I am nit a Doctor nor researcher. Everything that I know is from my personal experience dating from 2004.

Chemotherapy is a system drug designed to kill the little bastards. In my case, Lupron injections and Taxotere and an old breast cancer drug, Adrimyacin - the red devil; alternated each week for six weeks as one cycle then rest for two weeks to repeat two more times over a six month period; plus some orals. Zytiga, in first line testing at the time was next if I needed it.

Zytiga is a hormone based drug. Early results are favorable in disease abeyance.

BTW, Taxotere with Adrimyacin are current treatments for metastatic breast cancer.

It is no surprise that ASCO has an article on chemo before Zytiga rather than the other way around. You will see more articles on early chemo with hormone therapy in the fight as more and more are understand past research.

May your spouse have many undetectables.

Gourd Dancer