Intermittent ADT/Zytiga?

[Db999]

Good morning 😃. Are there any trials of intermittent ADT/ Zytiga ? My MO says I can’t try intermittent because of the combo. Thanks 🙏

[6357axbz]

Sounds like BS to me. Both my oncologists at MD Anderson said IADT is a viable option for me and I take lupron and Zytiga (abiraterone). If it’s something unique about your condition causing him to say this that’s one thing but as a stand alone it’s BS.

I agree with Nalacrats.

[Db999 in reply to 6357axbz]

I need to call for second opinion .. may I ask who you see at MD Anderson ?

[6357axbz in reply to Db999]

My mo is Dr Tu. However there are many good MOs there. If you go for a second opinion I would take whoever they scheduled your appointment with.

[Db999]

No just that there are no trials with Zytiga ?

[LearnAll]

Being on Zytiga should not be a hurdle if you want to do Intermittent ADT.

The criteria should be how low is your PSA presently and what is your upper point where you are willing to restart ADT.

Its not relevant how long you have been on ADT.....the real thing is how low your PSA reached.

I am considering IADT as my PSA is 0.4 and I am setting my upper point at 1.5 for restarting

ADT. Will do PSA every two weeks. My MO has not approved it yet.

[Db999 in reply to LearnAll]

I have been <.1 for over a year ..

[mklc in reply to LearnAll]

Do you consider doubling time for restarting?

[LearnAll in reply to mklc]

I am in learning stage...do not know full criteria but the concept of intermittent or bipolar ADT sounds great. Want to know about these.

[Magnus1964]

I have been hearing more and more about intermittent Hormone therapy. It seems to me this is a theory someone thought up and everyone is ready to try it.

It seems to me that in the off times the next line of cancer cells as a chance to find a work-around.

[Db999 in reply to Magnus1964]

So you are not for it ? I know you have done it all ..

[Magnus1964 in reply to Db999]

It's just my humble opinion, it doesn't sound right.

[Shanti1]

Hi Db999-

Here is a small study exploring intermittent with Zytiga vs Lupron alone meetinglibrary.asco.org/rec....

My husband was on zytiga/xgeva/trelstar/prednisone for a year with PSA <0.006. He discontinued zytiga in May of 2018, and his last 3 month trestar injection was in May as well. His testosterone was in the normal range by Oct 2018. Our oncologist has set a PSA of 1 for starting ADT again, he is currently at a PSA of 0.36. At diagnosis my husband had a PSA of 10 and mets to lymph nodes, sacrum and lung. Currently scans are negative.

[Db999 in reply to Shanti1]

May I ask where is is being treated ?

[Shanti1 in reply to Db999]

We are at Oncology and Hematology Associates of West Broward in South Florida. We like our Oncologist because he will work with us, but he isn't an expert in Prostate Cancer. My husband presented the option of IADT to our oncologist, we all discussed the risks and the unknowns, and he supported my husband's decision to take a break. We monitored testosterone and ultra-sensitive PSA ourselves.

[Tall_Allen]

Yes, there was one. Maybe email this to your MO and ask for his comments:

urotoday.com/conference-hig...

[Db999 in reply to Tall_Allen]

Thank u . I’m going show him on Tuesday .. he has seemed so against it ..

[Tall_Allen in reply to Db999]

I suggest you email it in advance of your meeting to give hime time to review it. What I usually do is attach a note saying, "I'd like to discuss this with you when we meet."

[billyboy3]

I too am puzzled because it is what I have been doing. I think you need to be polite and ask your current doc as to why it could not be tried, worst case is you go back on it in a month of so if things go bad, so why not? Every break can be so important to allowing your body-and mind, to rebuild to take on another round, so less is always better. Keep us in the loop and remember, ALL docs are on our side, some are simply better and/or more experienced and/or willing to experiment more than others.

I would also remind you that the costs involved in IHT is more expensive in terms of more tests and medical time so can be a factor-which should not be the case, at least, without your being made aware of this as the main or contributing reason.

good luck pal!!!!

[Db999 in reply to billyboy3]

U are on iAdt with Zytiga

[billyboy3]

no, I am still lucky to be able to use Casadex but will soon move up, or is it down?! I think the same rules still can be applied but one should check on this. I also take my lupron monthly, for two reasons, first is I get to stop when my psa reaches it lowest level and in case I just need to stop for a break-side effects sometimes just implode as in this round, killing me in all ways.

I also am taking lupron in. monthly injections as I and my crew were NOT able to get confirmation from the Pharma that they did proper tests that the 3 or in particular 6 month versions, were still as effective as taking monthly. Thus, I think I have kept better control as well as continuous action and potency by taking the shortened one month version. The downsides are the costs of the drug, coupled with added medical-I have given my own shots often, depends upon how I feel. I used to do the muscle form into my quad-now that was an experience as the needles were much longer than dumping into the belly fat.

Ok,

[Ramp7]

Great question. I'm meeting with my MO in April. I'll forward this information along. He wishes to do both for 24 months. This sounds like an interesting alternative.

[Union98]

Personally I think you may need to consider a new MO. We all deserve a doctor that listens to us and while advising against an action, doesn't forbid it. There is no reason for him to say you can't try a treatment option because he doesn't think it's allowed. We are very lucky that our MO is flexible enough to allow changes to standard protocol - but our mindset (or more my mindset) from the beginning is to question everything and that we are equal partners in deciding treatments.

[D_Alden]

When I stopped Lupron/Zytiga last year my MO said while it is experimental he fully understands why I did so, QoL. His mantra has always been that I am the patient and treatment decisions are mine to make, he is here to support, suggest and order tests as needed. My Uro last December reviewed my history and said if he was in the position I am he would be doing exactly what I am with the iADT. My PSA has been undetectable now for one year, post ADT.