It has nothing to do with STAMPEDE. You are taking abiraterone + Lupron for 2 years post whole pelvic IMRT, with curative intent. The only thing to do now is let your T level come back to normal and see if there is any progression.
Diagnosed with metastatic PC to an inguinal lymph node on Mothers Day 2017.
Gleason 7 (4+3) a couple of low volume cores.
GA-68 PSMA PET MR confirmed biopsy proven local metastasis to 1 inguinal lymph node.
I was on Lupron for 4 months prior to:
Lupron/Zitiga/Prednisone for 2 years.
I stopped treatment on 11/30/19 due to 2 year end point of the Stampeed trial.
PSA fell from 8 to 2.5 on Lupron.
PSA has been steady at <0.06 for the last 18 months.
May of 2018, I had 9 weeks of SBRT to the prostate and prostate bed. Treated to 8 gy.
T remains a 7. Oncologist expects my T to increase to 50 in 90 days and return to baseline of 550 in a year.
My treatment plan was designed for a cure.
Biggest complaint on treatment was shortness of breath on exertion. It's still a problem. A likely side effect of the Lupron which can take a year to clear your body
Playbook is not written past this point. Plan is to watch the PSA as the T recovers.
Similar diagnosis and same plan for me. Have been looking forward to the 18 month mark, but guess that will just start the waiting game.
I have a Kaiser oncologist, and he said essentially the same thing, that after 2 years, he wanted to stop abiraterone/prednisone. Reason was there was no evidence to indicate longer than 2 years abiraterone would do anything for me. Also, he said if I felt strongly to continue, he'd let me keep taking it. My case very similar to yours (see profile).
I am thinking of going along with it as I am tired of taking the abiraterone and prednisone. Thinking, just get on with it.
Was there consideration of stopping at 18 months? That is my plan (I think), although my original diagnosis was GS 4+3 and T2CN1M0. I,be heard studies suggest 18 months may be enough.
My husband is on the same plan...G9, mets to pelvic nodes and one rib.
Johns Hopkins doc says 2 years of ADT/Zytiga/Prednisone along with radiation to prostate and wherever else they say and the goal is to stop treatments at 2 years. He said he would stop all treatment including ADT if all was well at the 2 year mark. So, that is what we are working toward for now.
She’s absolutely 100% wrong. I’m still in the STAMPEDE trial at 8 years. As to stopping Abiraterone, that’s ridiculous. The whole point of Zytiga taken with Lupron is that it stops the adrenal gland producing a pseudotestosterone, which would add a pathway for the PCa to mutate and become CRPC.
The results in the U.K. men on this regime have been remarkable. As my oncologist put it, “you bought a lottery ticket and won 1st prize”, because I had been randomly selected to join the trial in 2011. I have the documentation of the results after the first 3 years, which showed an increase in OS of 40%.
I’m at 8 years now after a dx PSA of 571, 7 major bone Mets and smaller Mets elsewhere. No dietary changes or supplements, a fairly healthy diet and alcohol whenever. I think those results speak for themselves.
Great news, I meet with my MO again in April, just deceived my first 3 month Lupron shot. He is talking about taking a similar path as you just described.
Similar here. Was stopping at 24 months then at 16 months they changed to 18. I think the trials show no better outcome after 18 months and that is word for what my doc had relayed. I’ve ask other drs and seems 18 months is it. Stopping in February unless he changes his mind. Of course my question is when will it return and what is standard treatment when it does. Find that out in February I hope.
Fantastic! Happy for you. My doc at MSKCC had me take Lupron and Zytiga intermittently for 5 yrs, during which I had 3 “vacations”. Each one was shorter then the previous one, although the first one lasted 17 months. After 5 yrs, a new doc took over my case and took me off the Zytiga but kept me on the Lupron continuously. After about 2 yrs, my PSA became measurable and started to rise about 2 months ago (.08 followed by .12) so I went back on the Zytiga. It dropped initially (from .12 to .08) but is now back up to .12 as of 3 weeks ago. Not sure if that’s a “flare” or if the Zytiga and Lupron are no longer keeping my PSA in check. I will find out later this week when I get tested again and meet with my doc.
I'm in the same position: Gleason 9 with 10 (!) pelvic lymph node mets in dec 2017, started lupron and zytiga in jan and feb 2018, radiation (hdr brachy + imrt + boost to invaded nodes) ending in October 2018. I have a thread about this, check my profile. PSA undetectable for the last 18 months.
So, I'm just hitting the 2 year mark.
My oncologist recommends I stop all treatment when I hit 2 years total treatment in a couple of weeks. Radiation oncologist would like me to stay on lupron another 8 months so I'll have 24 months after radiation ends. They clearly disagree. I'm thinking that 2 more months of treatment will give me 18 months total after radiation, and that might be a reasonable compromise.
The main problem is that all the research about 18 or 24 or 36 months of adt were done without abiraterone, and adt+abi is clearly better, so maybe less time is enough. There's only the one study on both abi+adt for M0N1 HS patients (non metastatic node positive hormone sensitive), and it was for 2 years total, and there's simply no data for anything else.
Incidentally, the M0N1 STAMPEDE subgroup data was presented separately at ESMO a few months after the July 2017 NEJM article, PM me if you'd like the slides. It looks pretty good!
We should maybe start a M0N1 STAMPEDE group or sub-board since as time goes on more people should be joining our little group of early adopters.
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Is radiation still a good idea? Can APC be cured (until last week I always heard no)?
Whole Pelvic IMRT at Mayo or Local?
T2c N1 M1a
