zytiga after chemo

[Judymin]

Hi, my husband is having his 12th doxetaxol this Friday. His psa went from 35 to 5.8 but that seems as low as it will go. I asked doctor about trying zytiga again, he said won't work but I have read that sometimes it does. Does anyone have any information on this? So far he feels good, scans stable, cancer so far in lymph nodes only but concerned as psa never dropped to undetectable. thanks Judy

[DarkEnergy]

You can read my profile for treatment review, currently taking Zytiga, still at PSA <0.02.

So, your husband had Taxotere (Docetaxel) 12 infusions? Meaning two different episodes of 6 sets, 3 weeks apart of infusions? I've read your previous posts, but wasn't clear regarding the sequence of treatments.

Zytiga (Abiraterone) rechallenge after chemo is mentioned in this article:

onlinelibrary.wiley.com/doi...

[Judymin in reply to DarkEnergy]

Thank you. He had so far 11 Docetaxel. 12th set for Friday. First 8 3 weeks apart then 4 weeks apart. He had zytiga about 5 years ago great results for 3 years. After that was to have provenge but developed blood clot. Then on clinical trial zytiga and keytruda total failure. The oncologist not optimistic of trying zytiga again but will see

[Hidden]

He can also try a different anti-androgen like Xtandi and possibly have better results.

I'm on Zytiga now and chemotherapy is my next treatment. My doctor has said he wouldn't rechallenge Zytiga after chemo because it probably won't work. He did say he would prescribe Xtandi (enzalutamide).

[DarkEnergy in reply to Hidden]

"My doctor has said he wouldn't rechallenge Zytiga after chemo..."

Well, that's an opinion, not information, the link, provided data for one to digest. I can post links that suggests, if Zytiga fails, Xtandi - will follow failure as well, so I'll need to follow up links as "information only, may not suggest your personal treatment outcome"...

[Tall_Allen]

Try Xtandi next:

prostatecancer.news/2019/12...

[Tall_Allen in reply to Tall_Allen]

Or Xofigo if bone metastases and any pain

[Judymin in reply to Tall_Allen]

No bone Mets or pain thank God. Will ask about possible xtandi

[Hirsch in reply to Judymin]

What was your husbands lowest psa reading since being diagnosed??

[Judymin in reply to Hirsch]

I believe it was .08

[Cateydid]

I’m sorry I can’t help you. My husband is just now considering Zytiga and prednisone. I have read some horrible things about both, so keep looking for alternatives....

Considering Docetaxel for some time in the future, perhaps. He’s already done Taxotere once, with very good results.

Wishing you all the best!!!

[Judymin in reply to Cateydid]

Hi my husband did zytiga with prednisone for 3 years great results and no side effects at all

[Cateydid in reply to Judymin]

Thank you so much.

[Patrick-Turner]

I had 5 Docetaxel shots in 2018 and Psa just went up from 12 to 50. Then after a month it went down to 25. Then I had Lu177 and got a long time for Pca reduction.

Men respond differently to the same treatment.

Psa 35 to 5.8 is a large Psa reduction but the Psa may not tell doctors exactly what your husband's Pca status is and I suggest he get a PsMa Ga68 PET/CT scan which may show where all his Pca is located.

If he has had 12 Docetaxel shots he must be feeling a weakened, because that is a lot of chemo to have, and side effects of neuropathy may be bad, and recovery from this is very slow.

The time of effectiveness of chemo varies, but may be 12 months then Psa could rise, but docs told me chemo would not work well and it didn't, so its why I went to Lu177 without dithering around.

Its now well known that chemo often makes Pca sensitive to more doses of Zytiga or Xtandi,

and if your husband were to get Lu177, the addition of Xtandi may make the Lu177 more effective than it is without taking Xtandi.

Your husband may have Pca in his bones. But if not, its just luck, or else bone mets are too small to be seen by any scan, but PsMa scan is best to find out where the Psa is between 0.2 and 10.

Lu177 is particularly effective in killing Pca mets in soft tissues, and I had countless lymph node mets but scan last August after Lu177 and last month showed no soft tissue mets.

I do have some active bone mets and I am getting more Lu177 next week and docs think it should work well. I am taking Xtandi, which is not keeping Psa low but may make Lu177 work better. I will also begin with Veyonda, aka Idronosil to further boost effectiveness of Lu177; well, that is the hope, because its experimental for me.

Lu177 is good on bone mets but takes more time to work, maybe 3 doses before action on bone mets is large. But I don't know what will happen this time, and hope is that I only need 2 shots to kill off the remaining Pca bone mets, or at least suppress their growth for another 18 months.

I live in Canberra, in Australia, not far from where I get Lu177 in Sydney. For men in USA, most have to travel to Germany. C19 virus may interfere with OS travel.

Patrick Turner.

[Judymin in reply to Patrick-Turner]

Here in USA hard to get psma scan or lu177 and travel with the virus not possible. So far he feels great from chemo no nueropathy. Scans show lymph node bone scan clear

[Patrick-Turner in reply to Judymin]

But if you cannot get PsMa Ga68 PET+CT scans, it means you must have had only CT scans which cannot see Pca mets so easily.

PsMa scans will show mets about 2 years before all other scans.

My scans before 2016 showed no Pca mets, but as soon as I had PsMa scan I saw 2 lymph mets, and then in 2017, there were many more, and many more in 2018.

Anyway, getting Xtandi may be good idea now, but Cosadex, Zytiga, Xtandi are all usually added to plain ADT with Luron, Lucrin, etc, and all these hormone manipulation drugs just don't work for very long, and my Pca mets grew while I was on these drugs, but at a slower rate. Chemo failed, so I found I could access Lu177, and I had a good response after 4 infusions. But Psa is rising again and I need more.

For those unable to access Lu177, maybe adding Carboplatin to chemo like Cabazitaxel or Docetaxel might work, but I know only too well how chemo just may not work.

I only had 5 Docetaxel shots and I still have bad neuropathy. Nevertheless, I can cycle 200km a week.

Patrick Turner.