Patients with Zytiga

[docbulldog]

should I continue to have patience with Zytiga and prednisone after two months on the regiment. My PSA has not moved down, instead climbed from 12.9 to 17.1. I completed almost 3 years on Xtandi and a recent genetic study showed I am negative for Braca I and II. Looks like my only choices would be to start chemotherapy.

[tango65]

When treatment with zytiga or xtandi fails, doing chemo with cabazitaxel is more effective than using xtandi or zytiga..

nejm.org/doi/pdf/10.1056/NE...

You could request that they change prednisone for dexamethasone and see if you could have a positive response with zytiga at least for a short time.

[docbulldog in reply to tango65]

Thank you, very good advice. I will try to line up dexamethasone first, and then check more into which chemo I should start with if nothing changes.

[tango65 in reply to docbulldog]

Best of luck,

[Hidden]

I did the Dexamethasone switch and I am now 7 months in with undetectable PSA. It's something you could try, but when switching from one anti-androgen to another, the response is generally not good or doesn't last long.

In general, it's better to go with chemotherapy after Zytiga or Xtandi. The response is better and longer since chemotherapy is not affected by the typical AR-based resistance to anti-androgens.

[docbulldog in reply to Hidden]

When you’re on prednisone did your PSA go up, so then you switch to the replacement? I will check on Dexamethasone with my oncologist with hopes it will turn things around.

[Hidden in reply to docbulldog]

My PSA went up to .79 and I asked my doctor to start.

[Tall_Allen]

Yeah- looks like Zytiga is a non-starter for you. Sometimes you can rechallenge after chemo.

[docbulldog]

I appreciate these responses. I am checking on trying dexamethasone 1st and also will talk more with my MO on starting the chemo route. I will continue to be strong.

[j-o-h-n]

"I will continue to be strong." That's the ticket.....yes sir stay strong....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/21/2020 7:06 PM DST

[GoBucks]

You completed 3 years on Xtandi. That's good. After you try chemo maybe you can go back on Xtandi. Others with more knowledge should know if that makes sense.

[docbulldog in reply to GoBucks]

That would be wonderful if I would be given the opportunity to get back on Xtandi again. Right now I am trying to learn what plans are available with Docetaxal. What are most clinics advising? I hear about the "every 3 week" plan and also "3 times a week" for several weeks. I will find out more in 2 weeks but would like some advice please.

[GoBucks in reply to docbulldog]

You asked a question in response to my comment that deserves its own new topic. Or use the search button and I am sure you will find many posts. Unfortunately I do not have any answer for you.

[FinalBossMatt]

Just curious, what was your PSA when you were first diagnosed? I was 2450. My old doc didn't worry about jumps in PSA unless it was evident that the medicine wasn't working anymore.

Was it the first month or a combination of months?