New Abiraterone (Zytiga) formulation

[DarkEnergy]

A promising new oil-base oral formulation of Abiraterone in the works! Claims to improve the drug's "effectiveness by 40 per cent".

For me, the mention of side effect improvement of joint swelling and diarrhea, is great.

eurekalert.org/pub_releases...

[pjoshea13]

Some have been using lower doses & taking it with a meal - presumably with doctor approval. A very fatty meal can raise levels tenfold, meaning that as little as a tenth might be therapeutic. Perhaps it should be disolved in a little olive oil first. I'm not suggesting it since I'm not a doctor & one needs to test to ensure a therapeutic level is reached, but if I had to pay for the drug ...

-Patrick

[DarkEnergy in reply to pjoshea13]

Hi Patrick,

My next Oncologist scheduled visit is coming up soon, thus prepare topics for discussions. One of them is my Abiraterone 1000mg dosage, with the possibility of reduction as you mentioned.

I'm closing in on 3 years of Metastatic Hormone Sensitive Prostate Cancer (mHSPC) condition, so progression is on the mind...

[Hidden in reply to DarkEnergy]

Put it out of your mind. I’m at five years . Let’s not predict bad on ourselves .Take care over there .✌️

[DarkEnergy in reply to Hidden]

I know, at least beyond the "why me" recurrent mental anguish cycles!

Cheers

[Hidden in reply to DarkEnergy]

Been there done that. Why me? Poor moi? I’m not worthy to walk this earth .? I Had all of these

[podsart in reply to pjoshea13]

What factors go into the decision to use Zytiga versus Xtandi?

[pjoshea13 in reply to podsart]

Interesting question. Zytiga got FDA approval in April 2011 for mCRPC. Xtandi gained FDA approval in August 2012. So doctors had 16 months of Abi experience before Enza appeared & may have hesitated to use the new drug.

From someone who has experience of both: I was told that many of his patients had a tough time with Enza. However, the patients who failed Abi went downhill fast. Johann de Bono spoke about there been no protocol to treat patients who fail either drug. We know that these superior drugs have treatment-emergent AR-axis mutations that are more difficult to manage than classic ADT adaptations. I think that men should discuss the issue with their docs & find out how they make the decision - & what plan B is.

-Patrick

[DarkEnergy in reply to pjoshea13]

Now that Taxotere, Abiraterone, Enzalutamide and Apalutamide are used for Metastatic Hormone Sensitive Prostate Cancer (mHSPC), it gets blurry when reading posts here.

ncbi.nlm.nih.gov/pmc/articl...

[pjoshea13 in reply to DarkEnergy]

It's tempting for me to sound like an old codger & say: "Back in my day, you were on Lupron until refractory & then Taxotere for a little while & then it was all over." It had long been that way & that contined for a while.

Then suddenly there were options & the mathematics of combinations & sequencing became mind spinning. & just when studies seem to point the way, new drugs appear.

Alas, none of the combos & timings eradicate the cancer yet.

-Patrick

[podsart in reply to pjoshea13]

Thanks

[Hidden]

Good news! Thanks dark energy!😷

[Patrick-Turner]

The revised formulation of arbiratone acetate uses a smaller dose, 70% of what is normal for Zytiga. I saw on the bottle in a photo at link the new version is called Ozytiga, and it was developed in state of South Australia.

But the article at eurekalet.org/pub_releases says the drug is 40% more effective. Does that mean the mean time for it to remain effective in suppressing Psa is 40% longer than the mean 8 month time for normal Zytiga?

Trials of Ozytiga will not begin until another 2 years, so we all can forget about that one for 2 years at least, maybe 3, if it gets through trials. I found Zytiga worked for me for 8 months and main side effects were disturbed heart rate especially in hot summer weather. The drug interferes with testosterone production in adrenal gland, and anything that disturbs operation of this gland probably disturbs the production of Adrenalin, and how heart rate is regulated during exercise.

The number of mets I had before I took Zytiga increased while taking the drug, Psa suppression was fairly weak, with Psa going down from 6 to nadir of 2, staying there for 2 months, then rising back to 6 slowly in the 8 months.

IMHO, I doubt eating a meal rich in fats or oils or trying to dissolve normal Zytiga pills in olive oil before taking them to make them 10 times more effective is going to work.

Does 10 times more effective mean holding Psa low for 80 months, or 6.7 years instead of only 8 months? Its too good to be true.

Pca treatments are not only about keeping Psa low, its about halting the progress of Pca and stopping new mets from forming.

What do we want? A Pca treatment that kills Pca cells,

Wennawee wannit? Right Now.

How do we wannit? With few side effects.

I doubt I could take Zytiga again and get any benefit. it now seems Xtandi has stopped working, but may be making my Pca express more PsMa, so more Lu177 will work better, but any change to Zytiga is presently thought to be a waste of time, and our Medicare would not fund it here in Australia.

Patrick Turner.

[Hirsch in reply to Patrick-Turner]

It has nothing to do with synthesis or action of adrenaline

[Patrick-Turner in reply to Hirsch]

I take your point. I am not a doctor who is trained to know the function of every organ fairly well.

But while taking Zytiga, it was OK for first two months and in early winter of 2017, when I recovered from having both knees joints replaced, I rejoined a Sunday cycle group in late winter and cycled with them for about 3 months until weather warmed up and HR went a bit crazy. The first time I had HR trouble was at early in this 3 months, and one Sunday at about 5km after start of an 87km ride. At the top of a long upward hill we all stopped at a set of traffic lights, and heart was still going strong as it was up the hill to get just in front of all the others, but when I stopped at lights, HR continued strongly, when it should have immediately eased off. That gave pulsing pains up my spinal column and I thought I might die, or head would blow off, so I kinda froze, but within 20 seconds the pulsing pains stopped. I thought I might die doing what I love, so I completed the ride OK without the same problem happening. Later in 2017 the same bother happened on smaller hills when I reached the tops of hills and eased off the power and a bit more often, when weather warmed, so I gave up the group and rode alone early on Sundays and other summer days. So I could feel the unsettling effect of poor HR control due to Zytiga, but it all went away a month after I quit Zytiga and began chemo. in 2018. What was I to conclude? 3 of the 10 listed side effects of Zytiga relate to heart function.

I included more potassium in my diet with english spinach and button mushrooms which seemed to help, despite blood tests showing potassium levels were ok.

Trying to remain an older functioning athlete while being treated for Pca with one drug after the other does seem to have a down side, but I did not die. In 2017, I proved to the others in cycle group that I could cycle faster than them over a long distance without any testosterone, and with a darn drug that tempted me to quit. many in the group were younger, and had been cycling for years.

But right now, I still suffer long term side effects of chemo but my cycling speeds are remaining high enough and on known routes of 27km across town I am still doing good speeds. I have no problems with irregular HR now, and my heart doctor is not worried I'll die on the bike, but if he and myself are wrong about this, and I do die, well its all OK, meant to be, and my last words might be "Such is life".

I don't plan to live while wrapping myself up in cotton wool and lazing about to avoid what might happen.

Yesterday I did a short ride of 53km, but it was 10C when I left, 9C when I got back, and because most ppl have returned to work after C19 lock down, hardly anyone else was out cycling on such a cold day. I felt really good when I returned.

I was able to figure out how zoom worked after emailing a friend, so I'll be ready to contact a doc on Friday using zoom.

The slow availability of abiraterone acetate disolved in oil or fat could be due to patents and legal restraints. In other words, mumbo-juumbo red tape. But trying to mix existing Ztytiga pills in oil at home before taking it could be dangerous because there may be some added chemistry involved that is necessary, that nobody knows about.

The cold mornings are making it impossible to do much early in my shed.

So I try to spend time with you all instead.

Its a nice cool day here, I'll get into shed soon, to achieve what I want.

All the best folks,

Patrick Turner.

[Flash64]

Odd that they're saying the dose only drops from 1000mg to 700mg when, as Patrick has pointed out, the right mix of fat with Aberaterone requires only 100mg to be effective. Also a bummer that this won't hit the shelves any time soon, especially since this seems like a straight-forward modification to the existing protocol.

-Andrew

[MateoBeach]

Much more effective for the company making and selling the branded drug as it allows them to renew their patent now that generics are available.

[youngigor]

Have been on lower dose (250 mg/day) for over a year now, after almost a year of 1000 mg/day before that. The hi dose caused muscle cramps (significant) and some stomach cramps (minor). Did research and found a low dose study based on 72 patients, and my UO agreed to trying the new procedure. In my case, I take it w/ a healthy lunch (has some fat) - much easier to tolerate than 1000 mg in fasted state - now no stomach cramps, rare muscle cramps. PSA not detectable for last 20 months or so - LT 0.1 was the limit of the test used, presumably so I wouldn't freak out due to minor variations in an ultra sensitive test.

The University of Chicago reported on, and summarized, the study test results:

uchicagomedicine.org/forefr...

The original study is :

ascopubs.org/doi/full/10.12...

(I may have the original study wrong - didn't notice a reference to a McDonald's Big Breakfast in this one, and recall a caution that it wouldn't be ethical to prescribe AA + a Big Breakfast and didn't notice that in the study referenced above)

Taking it with food doesn't mean you'll live longer, just that for a given amount of Zytiga in your body less Z need be taken if taken with food.

There's a contrary view - that this approach is of "little consequence" and suggests waiting for a new AA formulation, less dependent on food be used. I don't agree with these folks, but present their views so my brothers can make up their own mind.

ascopubs.org/doi/10.1200/JC...

Caution:

Whatever dose of prednisone is need to offset the effects of AA may need to stay the same. W/ my low dose of AA was also instructed to reduce by 3/4 the prednisone dose, which led to serious troubles - couldn't walk more than 5 minutes. Now at 1/2 the original dose of prednisone and am almost back to normal, i.e., now do 45 minute walks with mild knee pain.

[Wings-of-Eagles]

I would not too enthusiastic about it until there are some Vvalid trials. Sounds a bit too much the cure all "snake oil"