Changed prednisone to dexamethasone with Zytiga; lowered PSA after one month

[Grumpyswife]

It's been advised on here by others but I wanted to update for others in our situation--where enza quits working and Zytiga may get a boost from the change.

The MO easily agreed to the switch to dexa in January when my husband's psa rose 2+ points to 13.56 on 1/6/20.

After using dexa for about a month along with Zytiga (brand) his psa on 2/10/20 dropped to 11.89. Husband also loosely follows the Tippens protocol with fenben but now takes it 4 days a week.

The local MO is against chemo for my husband because he is asymptomatic for pCa and has cognitive issues (Alzheimer's diagnosis) already.

All of his other bloodwork was "better then most young people's" including liver tests. He was slightly anemic as usual. We were happy.

[LearnAll]

Thanks for this info. It confirms the study that there are medicines which can prolong effectiveness of Abiraterone after it stops working. Change from prednisone to Dexamethasone is one such strategy to make Abi last longer.

[Hidden]

Hope the steroid switch continues to work for him.

I am also about to start Dexamethasone with Zytiga. My doctor said that so far, it worked on 1 out of 3 patients. He also said that the patient it worked on had a significant PSA reduction that lasted 6 months. That's really hopeful.

From the results of the SWITCH trial, just under one half of patients had a PSA response. I'm hoping my good PSA response will change my doctor's small sample to 2 out 4 patients.

Let us know how things go.

[Grumpyswife in reply to Hidden]

At this stage we’d be thrilled to get 6 months’ improvement.

[ctflatlander in reply to Hidden]

Hi Gregg, I saw my MO yesterday and wasn't able to convince him to make the switch from Pred to Dexa. I was undetectable for 8 mo's now at .2 Did you use the Switch trial evidence?

I need to do more research and but haven't given up. Thanks Bob

[Hidden in reply to ctflatlander]

Yes, I used the SWITCH trial as evidence. My doctor knows I read a lot about prostate cancer and has even complimented me about it.

We had a discussion sometime ago about the SWITCH trial. I tried to get him to put me on Dexa from the beginning and he wouldn't agree to that. He was only willing to consider it now that my PSA has started going up. He said he had three other patients so far that tried it so he hasn't been doing it for too long.

His attitude was: "If I thought it could hurt you I would not agree to it." so while he wasn't comfortable doing it from the beginning, he was OK based on the SWITCH trial. I think that's reasonable. They have lots of data with Zytiga + P, but not much with Zytiga + D.

[Hope59]

Great news for your husband!

My husband just switched from Prednisone to Dexamethasone last week. His PSA increased in one month from 0.7 to 1.4. I emailed to request the change and the MO called it right after.

Hoping for similar results!