Extending Hormone Sensitivity After Zytiga Failure

[6357axbz]

I think I recently saw a post here about a study, maybe even a clinical trial result. showing one of the non-chemo meds significantly extended the hormone sensitive state after Zytiga fails but I’m unable to find it. Anyone remember seeing this? It may have been one of the meds ending in “ide”, or possibly Xtandi??? Thanks

[Tall_Allen]

Here ya go:

bjui-journals.onlinelibrary...

[Tall_Allen in reply to Tall_Allen]

Perhaps you meant that the combination of apalutamide (Erleada) and Zytiga extends progression-free survival (but not overall survival) of Zytiga?

janssen.com/janssen-present...

[6357axbz in reply to Tall_Allen]

Thanks. It may have been the latter one, the Janssen study. It probably caught my eye cause it was a reasonable next step after going HR without chemo.

[dhccpa in reply to Tall_Allen]

How would you explain why there can be better progression free survival but not overall survival? In the first group the PSA and mets catch up in a sort of mad rush toward the end? I've read those terms repeatedly and am tired of pretending I know their exact meaning. Thanks!

[MateoBeach in reply to dhccpa]

PFS can be measured and reported earlier than OS which requires half of a cohort to die. A terrible thought. ItMight be reasonably expected that improved PFS will ultimately translate into improved OS.

[Tall_Allen in reply to dhccpa]

You understand it well. The full results haven't yet been published, but given the length of follow-up of 55 months, I'd guess that median survival was reached, but that the difference wasn't significant. I like your description as "catch up."

It suggests to me that the combination has value, but that it is optimally used earlier, while it can still make a difference in survival.

[Magnus1964]

I was on a trial with xtandi + Another drug from Johnson and Johnson which was supposed to extend the efficacy of xtandi. I was on the trial for four years. I never did find the name of the mystery drug.

[winkoliu]

It might be Niclosamide. Search on google you will find some studies.

[MateoBeach]

Niclosamide with Abi to treat ARV-7 resistanceurotoday.com/conference-hig...

niclosamide.org/cancer-type...

[TeleGuy]

Were you thinking about switching prednisone to dexamethasone as per the SWITCH trial (google or see other posts on this site?). From your post a couple of months ago it looks like you are already on dexamethasone so this might be irrelevant to your case.

[6357axbz in reply to TeleGuy]

You are correct. My MO switched me to dex, in lieu of pred in June 2020. I had been on Zytiga since April 2019 except for a holiday from about December 2019 thru June 2020 when PSA had risen to 0.5, other than that holiday period my PSA has been undetectable since the end of 2018.

[GeorgeGlass in reply to TeleGuy]

is that a switch that only is done when used with zytiga?

[TeleGuy]

I was referring to the SWITCH trial in which patients on abiraterone+prednisone were switched from prednisone to dexamethasone and it extended the effectiveness of abiraterone. Here's one link: nature.com/articles/s41416-...