Zytiga ineffective after 12 months

[Evans71720]

Zytiga is no longer effective, was 1st diagnoses in Nov 2018 with widespread Mets, 9-10 Gleason, and PSA above 1200. I realistically expected to see 10-18 months benefit from the chemo which is what I got. Initially tried docetaxel but had complications. What are the suggestions for my next line of treatment? My mother died of breast cancer, so I’m debating if genetic testing for mutated BRCA genes could help. I’ve seen articles listing success with olaparib but generally seem to have minimal benefit. Extended OS of 3-6 months. Thanks for the help. God speed to all others fighting the disease

[Hidden]

I would definitely want to have molecular testing done for BRCA and other genetic mutations.

If you got 10-18 month benefit from Docetaxel, then it worked well for you so you could discuss rechallenging it with your doctor. Or you could go wth second-line Cabazitaxel (Jevtana). My doctor said that if the response is good, you "go back to the well" otherwsie go to second-line.

What complications did you have with Docetaxel?

[Evans71720 in reply to Hidden]

Developed widespread sores on skin throughout body. Once was worried could develop into more serious side effects if we continued, so only completed 1 fusion of docetaxel

[Tall_Allen]

A germline test for BRCA mutations is simple and cheap, so why not. Just call your doctor to order it. They mail a kit to your home. You provide a saliva sample and mail it back. It's that easy.

pcnrv.blogspot.com/2018/02/...

It's not a bad idea to get a biopsy of one of your metastases too. That may provide some useful info through morphology, IHC, or genomics. Usually not - but what is there to lose?

You couldn't tolerate docetaxel, but what about cabazitaxel?

pcnrv.blogspot.com/2019/12/...

The combination of Xofigo and Provenge may be particularly good.

[Evans71720 in reply to Tall_Allen]

Oncologist has yet to ever mention cabazitaxel as an alternative. Just guessing by the name but is it produced from the taxone family? Pretty sure that’s what I was intolerable to the first time

[Tall_Allen in reply to Evans71720]

It's possible to be intolerant to one and not the other.

[2dee]

Quit screwing around, get Genetic Counseling, they will order the Genetic Testing.

If you have mutated BRCA1/2 then other treatments become available. We likely need all the options.

Also you can help your bloodline better judge their individual choices.

My mom died breast cancer at 53. An aunt and 7 of her children, my cousins, all died early of conversation.

Thanks to our grandpa.

I've had 4 different cancers. Stage 4 PCa 2018 with 1300+ PSA, given 6mos. Obviously I'm still here and not doing too badly.

2Dee

[2dee in reply to 2dee]

Spell checker had a brain fade. They weren't talked to death, all got some type of cancer.

2Dee

[dagreer in reply to 2dee]

Ah - I thought you meant they talked instead of acting fast and so passed sooner. It made sense.

[HopingForTheBest1]

Zytiga was only effective for me for 6 months. Had genetic test, and was found to be BRCA2+. This explains how I have an aggressive form of this disease; Gleason 10 and stage 4 metastasis to the bone.

Precision medicine determined I needed to be on Olaparib, PARP inhibitor, in addition to Eligard and Xgeva. It has been over a year on Olaparib with my PSA having been undetectable to date. Also had Provenge immunotherapy treatment 1 year ago.

Absolutely get genetic testing!

[j-o-h-n]

And God speed to you fighting the disease....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 03/21/2020 4:05 PM DST

[tom67inMA]

Be careful with statistics. Many of the newer drugs show very modest improvements in median survival, but that doesn't capture that the survival curve flattens out at some point after the median. Translation: some lucky people get miraculous results that aren't reflected in a simple median.

[Evans71720]

Thanks for the support and replies on here for dad. Unfortunately he passed in late September. Oncologist never ordered/recommended genetic testing. Dad only tried Xtandi for couple of months with no change to the runaway PSA velocity we were seeing. Then that was it.....not sure why the hell he never received anything else. Oncologist said he had no further treatment options, dad was put on hospice and made it 3 more months.