1/4 dose enzalutamide for MCRPc work... - Advanced Prostate...

Advanced Prostate Cancer

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1/4 dose enzalutamide for MCRPc working for 4 years in 87 yr. old

George71 profile image
10 Replies

ABSTRACT

BACKGROUND: The management of metastatic castration-resistant prostate cancer involves second-generation antiandrogen therapy, including enzalutamide. The recommended dose of 160mg/day is sometimes difficult to use in elderly patients because of the burden of comorbidities. The usefulness of a low effective dose remains unclear.

METHODS: We report the first ever patient, now aged 87 years, who had progressing prostate cancer and was treated at 25% of the recommended dose for over 4 years.

RESULTS: The most striking observation is that nothing extraordinary happened. The disease responded without dramatic toxicities. His follow-up has been serene on both aspects of prostate cancer and general health.

CONCLUSION: Cautious dosage can have a long-lasting favorable impact in the elderly patient.

docwirenews.com/condition-c...

PMID:33657823 | DOI:10.48095/ccko202169

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George71 profile image
George71
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10 Replies
Shooter1 profile image
Shooter1

I'm only 70 till next month. 1/2 dose working for me 2 yrs..hoping for 8+more.

RICH22 profile image
RICH22

Congrats! I've been on low dose (50mg) bicalutamide since June, 2018, PSA <0.1 - tested every 3 months but last test was 6 months ago. Labcorp posting results this coming Tues. We shall see. 74 yrs old and holding!

MateoBeach profile image
MateoBeach in reply to RICH22

Is that bicalutamide alone or added to ADT?

RICH22 profile image
RICH22 in reply to MateoBeach

bicalutamide (casodex), with finasteride and tamsulosin, to help keep tubes open due to enlarged gland.

MateoBeach profile image
MateoBeach in reply to RICH22

Sounds good. Similar to what I did except dutasteride instead of finasteride. Worked well for over 4 years.

RICH22 profile image
RICH22 in reply to MateoBeach

i tried dutasteride instead of finasteride, since the dut. hits pca cells as well as healthy prost. cells. Found i couldn't control incontinence as well, so went back on finast. But i still have my gland, so we have different situations.

EdBar profile image
EdBar

I’ve been using Xtandi for five and a half years and have been on a half dose for two and a half and it is still working. The 160 mg SOC was the maximum that could be tolerated when it was going through clinical trials.

Ed

George71 profile image
George71

Many seem to think getting to undetectable will somehow cure them... rather than lowering PSA to a stable low number and trying to control and slow the progression over a decade or two. That way the cancer doesn't become as aggressive. Driving the PSA to as low as possible with high doses rather than dropping it 80% or so with half or one quarter doses may make the medicine last 2 or 3 times as long. Also the damaging side effects to other parts of the body may be less.

EdBar profile image
EdBar in reply to George71

When I was seeing Snuffy Myers his goal was always to drive cancer into dormancy, or long term managed remission. He felt that a smoldering, festering cancer allowed for nasty mutations to develop. Therefore he always tried to reach an undetectable level.

Ed

RICH22 profile image
RICH22 in reply to George71

totally agree. i'm ok with the side effects of the combo i'm using, largely because i'm 74 yrs old, single and live alone. To younger men, losing erection is devastating and gynecomastia doesn't make for a pleasant sight in the mirror but i'm alive, can still achieve orgasm and who knows? Maybe a woman could work magic on me! As some of us know, the fair sex have mysterious powers.... 😅

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