What comes after Lupron failure

[Buzy1]

Is there any treatment after Lupron failure

[Hidden]

Can you give us your treatment history?

Generally speaking, you would try one of the second-line ADT drugs such as Zytiga or Xtandi, both of which are approved for castrate resistant prostate cancer.

[Buzy1 in reply to Hidden]

I had my prostate removed in 2002...gleason 9. Had radiation to lymphs and prostate bed in 2010. Was on Zytiga with great success until 2018 when PSA increase about 5-10/ month. Tried Xtandi...no help. Had chemo and PSA dropped but came right back. Went to Germany and had 4 LU 177 treatments and 2 AC 225. PSA started to drop for two months and then it came right back up. Not sure what else to do

[Hidden in reply to Buzy1]

I would have a biospy done and molecular testing for treatable mutations and they also can look for neuroendocrine differentiation which could benefit from platinum-based chemo or a combination.

What's your current PSA and have you had imaging that shows progression?

[Break60 in reply to Buzy1]

Post this in your profile for future reference and keep it updated.

[Manilo in reply to Buzy1]

Just saw this about BAT plus inmuno

onlinelibrary.wiley.com/doi...

Also I read somewhere that quercetin might overcome enzalutamide resistance

I would also take the cholera vaccine. Doesn't seem to harm and trying is free.

There is also that cabergoline study to block prolactin. (Costello et al.)

[Manilo in reply to Manilo]

Extreme responses to immune checkpoint blockade following bipolar androgen therapy and enzalutamide in patients with metastatic castration resistant prostate cancer

[Tall_Allen]

Assuming you are metastatic, you would continue with Lupron and add any of docetaxel, zytiga, Xtandi, Xofigo (if bone mets), or Provenge.

[Buzy1 in reply to Tall_Allen]

I had my prostate removed in 2002...gleason 9. Had radiation to lymphs and prostate bed in 2010. Was on Zytiga with great success until 2018 when PSA increase about 5-10/ month. Tried Xtandi...no help. Had chemo and PSA dropped but came right back. Went to Germany and had 4 LU 177 treatments and 2 AC 225. PSA started to drop for two months and then it came right back up. Not sure what else to do

[Tall_Allen in reply to Buzy1]

Jevtana with or without carboplatin. Have you had any metastases biopsied?

[barrybayarea in reply to Tall_Allen]

I have been asked that question too, if I have had the metastases in my lymph nodes, biopsied, the answer is no. My doctor does not see the point in doing it. What is the advantage of this biopsy? Can it possible show mutations that can be treated different that the prostate biopsy? Which by the way, showed no mutations.

[Tall_Allen in reply to barrybayarea]

The prostate biopsy is irrelevant at this point. There are a few rare genomic mutations in the metastasis that have specific treatments, like MSH2 or BRCA.

[Hidden in reply to Buzy1]

8 years on zytiga gives hope to many. Thanks

[Hotrod65]

You will move into your Anti Androgens and combo therapies to possibly include chemo.

[squidlicious]

I’m non-metastatic, Gleason 9, did not have surgery. I also failed Lupron after 12 years of control. Then I failed Zytiga. Then I failed cryo. Then I failed chemo. Now, however, Lupron is working again in combo with Apalutamide (Erleada).

[Hidden in reply to squidlicious]

Lupron gave you life ..12 years is remarkable ..👏🏼

[Boywonder56]

Ok ....riddle me this ive been on the loop / earleda train for 30 mos....now its failing .....im thinking of just taking vacation from all the poisons...im sure the collateral damage is permament...but i think realeasing thineself from this fn fog ...would be priceles...no matter the outcome....p.c. the slow dancer. ...

[Hidden in reply to Boywonder56]

If your psa is rising I would not chance a vacation until you are far into undetectable ..again .. Im castrated and only dream of t returning. Still my mo won’t ok a vacation for me .. I follow the dr .. I doubt if your dr will recommend a vacation right now. On the other hand , I’m no expert either..

[Boywonder56 in reply to Hidden]

Yes whimp ur correct none of my docs will allow it either...soc.....but arent we masters of our own destiny....

[Hidden in reply to Boywonder56]

Hahaha 😂 . Maybe? Kind of ? Not really? I gave up thinking I was master of anything when APC drug me to the ground the first time. I’m humbled by this beast . I thought I was master in charge of life before.