Xtandi+Keytruda may still work after Xtandi alone fails

[Tall_Allen]

In a small trial, 5 of 28 men (18%) got a PSA response (dropped at least by half) from the combination even after Xtandi alone failed. Median survival among responders was 42 months (some still alive at follow-up) vs 19 months for non-responders. It is not clear how to choose those who will respond based on tumor biomarkers.

jitc.bmj.com/content/jitc/8...

[wpopomaronis]

Thank you!

[MiRob]

Thanks 😊

[Haniff]

Interesting TA, thanks 😊

[Omc64]

Hi TA

Could I ask if this means if xtandi fails there are 19 months left...

Also do you know if pembro and xtandi together are being used in Europe in trials or as a treatment?

Thank you for your imput😊

[Tall_Allen]

It only means that in this group of 28 men, many of whom had already had abiraterone, chemo, and other therapies, 14 of the non-responders to the combo therapy lived longer than 19 months. It is not generalizable.

There are these trials of the combination in Europe for mCRPC:

clinicaltrials.gov/ct2/show...

clinicaltrials.gov/ct2/show...

[Omc64 in reply to Tall_Allen]

Thank you Tall_allen appreciate that info😊

[ctarleton in reply to Omc64]

Also from the link Tall_Allen originally provided, it might be noted that the trial participants only got 4 rounds of Keytruda, and that due to the relatively small numbers involved there was a considerable 95% Confidence Interval range in the Overall Survival for individuals on either side of that Median value of around 19 months.

"For the 23 non-responders, median follow-up time was 36.5 months;

median PSA PFS time was 3.1 months (95%CI: 2.8 to 4.4 months);

median time to subsequent treatment was 5.2 months (95%CI: 3.8 to 8.5 months);

and overall survival was 18.6 months (95%CI: 13.4 to 26.4 months)."

When it comes to individuals, sometimes "The Median Isn't the Message".

(See also the Classic essay by Stephen J. Gould)

edwardtufte.com/bboard/q-an...

[Peterd110]

Thank you!

[sotee888]

Hi in your opinions would keytruda and xtandi work with someone who has advance bone mets (super scan) and hemo below 8?

Thanks

[Tall_Allen in reply to sotee888]

Super scans with low hemo is a special situation. Is that what your oncologist is suggesting?

[sotee888]

No I just saw your post and thought it could be an option. My friend has done the Lu 177, chemo, zytiga and now in Xtandi. Dr’s as you would say do not have anything yet they can think off from the tool box. Thanks

[Tall_Allen in reply to sotee888]

I wish I knew more about it, sorry. I would think that Xofigo+Provenge might be useful, but the low red blood cell numbers may preclude that - perhaps discuss with your oncologist.

[sotee888 in reply to Tall_Allen]

Thanks for your input