Xtandi effectiveness

[GoNapoli]

Hello All! I am checking in with those members who are on Xtandi, when did you start to see an decline in PSA? My Father is only three weeks and unfortunately his PSA is doubling. Next move if Xtandi doesn't work is Abiraterone after his Provenge infusions are over.

[tango65]

If Xtandi fails the following treatment with chemo seems more efficacious than using other new antiandrogen like abiraterone (zytiga).

nejm.org/doi/full/10.1056/N...

pubmed.ncbi.nlm.nih.gov/302...

[ctarleton]

Anecdotally, I started Xtandi in Nov 2016 with a PSA that had risen back up to 95.0. By Feb 2017 the PSA was down to 6.2. By Sep 2017 a low point of PSA 1.2 was reached. Actual radiological impressions on scans were not huge. A PSMA PET scan did show several "hot spots" as my PSA had risen to that level. Xtandi worked quite well for me for a few years afterward. (I also started Xtandi shortly after doing Provenge. Summary details in my Profile.) Individual responses, of course, can be different.

I know it can be nerve wracking, but PSA is just one of several indicators in making a treatment stop/change decision.

[RyderLake2]

Hello, I started Xtandi (enzalutamide) in mid-September 2017. Although not high, my PSA had been climbing steadily for a number of months prior (1.3, 2.4, 3.4, 4.2). I was switched from a radiation oncologist to a medical oncologist at that time and he recommended Xtandi. The effect was immediate. In two weeks, my PSA was 0.20 and by mid-October 2017 it dropped to 0.044. By mid June 2018 it reached undetectable at <0.008. It is now three years and four months since starting this drug and my PSA is still extremely low (0.011). Are there side effects? You betcha! The two biggest ones for me are fatigue, some neuropathy in my right foot and a little brain fog. The last one could be old age. I am 75. As Charles and others have mentioned everyone is different. Good luck!

[john205]

After docetaxel and with continued Lupron beginning in August 2018, my PSA dropped from 148 to a low of 0.16 in April 2019. It then rose slowly to 2.16 at the end of November 2020, a technical failure of initial treatment after almost 2 1/2 years. I began Xtandi at the end of November 2020. One month later my PSA was 0.311. I am very pleased and I hope it lasts. I agree with Tango 55 about the next step after Xtandi fails unless you have a mutation, like BRCA, that may qualify you for a PARP inhibitor, olaparib. Ask your oncologist.

[DenDoc]

I have the same experience with Xtandi. I have been on it for about 2 years following chemo. My tumor is a hybrid, Small cell and adenocarcinoma. PSA dropped from the teens to around 1.0 in a month and stayed there for a year. There is a slow creep now upward but I have just gotten to 4 so we are continuing to watch since I have no visible new lesions. Yes to fatigue but little else. grateful for good insurance when I see the cost of the drug each month and happy to pay a $30 co-pay.

[NecessarilySo]

I have had mPCa since 2012. My PSA had risen to 35 last June , after a vacation from adt, when I started Lupron + Xtandi, (then switched Sept. to Eligard + Xtandi) when Lupron had shortage), just seven months ago. PSA dropped to <0.1 over just a few months, June to October. Can't say I have SE's. I wonder why some people have troubles with it while others have none . Could it be ethnicity or race differences? Could it be diet? Or different types of PC? I was under the impression that Lupron cuts the testosterone from testes while Xtandi cuts T from adrenals, like bicalutimide. Sorry if I am wrong on that. As for metastases I think they are shrinking, (or is it my imagination?) I plan to switch to the daily pill version of Lupron/Eligard soon, (Orgoxyx), keeping on with the Xtandi, which is $25 a month for me copay. So I am pleased, to say the least. In fact, they have set me back five years. I am 75 now. Like reborn, with a new outlook for my future.

[FinalBossMatt]

I just started it in December. My PSA was up to 97 in November and taking it with Lupron, I've never felt better.

I know how it's both feels good and feels like a bummer if a medicine is working for one person but might not be working for you or your dad in this case, but unlike what a lot of wingnuts say with "Juicing cured my cancer" or this or that controlled it or made it go away, this isn't an exact science.

Good luck.

[GoNapoli in reply to FinalBossMatt]

Thank your for the response, my Father is feeling good overall he started the Xtandi 3 weeks ago. How long after beginning Xtandi did you see the PSA start declining from 97?

[monte1111 in reply to FinalBossMatt]

You got it. Lots of wingnuts. j-o-h-n especially could use some of his screws tightened.

[j-o-h-n in reply to monte1111]

Well you're the perfect monkeywrench to do the job..

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 01/26/2021 7:35 PM EST

[Hidden in reply to j-o-h-n]

Are monkey wrenches, Left-handed or Right-handed?

[j-o-h-n in reply to Hidden]

tail-handed..........

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 01/26/2021 9:52 PM EST

[ppulatie]

I saw PSA drop from 6 to 1.86 in the first three weeks. Currently at .4 (lowest that my PSA tests will detect) for 4 months. Been on it since Nov 8, 2019.

[Spyder54]

I just completed 1 mo on Xtandi and 3rd month of Firmagon. My PSA had gone down greatly, but last 30 days 4.7 down to 4.2 only, and Testoserone from 0.0% (which is primary food source for PCa) up to 17. Normal male would be 300+, so it may be a normal swing, but awaiting response from Xtandi Rep, and Urologist since results just posted over weekend.

[monte1111]

Lupron and 8 cycles chemo brought psa from 59.9 to about 7. Almost 3 and a half years of Lupron and Xtandi has slowly brought psa to <0.1 Fatigue and brain fog largest side effects. (Bad foot neuropathy began right after chemo was completed.) Cause? Abdominal lymph nodes no longer show up on scans, extensive bone mets are stable. So Xtandi is working so far for me. It seems like you just have to try and see.