Enzalutamide after abiraterone - Advanced Prostate...

Advanced Prostate Cancer

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Enzalutamide after abiraterone

Vsahay profile image
15 Replies

Hello everyone

My father has been on abiraterone since June 2018.His psa is continuously on rise since sep 2020.Although he is experiencing no symptoms till now, we are looking into other treatment options.

Has anyone had a good response with enzalutamide (Xtandi) after abiraterone?

*My father has not been on chemo yet.

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Vsahay profile image
Vsahay
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15 Replies
Tall_Allen profile image
Tall_Allen

Chemo in between may improve time on Xtandi.

Vsahay profile image
Vsahay in reply to Tall_Allen

Thanks for the reply😊

HB1966 profile image
HB1966

In my case, switching directly to XTANDI did nothing. The PSA has continued to rise. Maybe minimally slower. Chemo is probably the better option at this point. Best wishes Theo

Vsahay profile image
Vsahay in reply to HB1966

Thanks for the reply😊

There are mutations like AR-V7 that make the cancer resistant to anti-androgen drugs like Zytiga or Xtandi, but not resistant to chemotherapy agents like Docetaxel or Cabazitaxel. So sequencing in chemotherapy may be effective against the cancer now and also make it possible to go back later and retry another anti-androgen successfully.

Magnus1964 profile image
Magnus1964

I went on xtandi after being on zytiga for 3 and 1/2 years. I had great results with xtandi. I was on it for 4 years.

immunity1 profile image
immunity1 in reply to Magnus1964

I am interested in your experience Magnus, given my unusual treatment regime including with Lu177 etc, and given the recommendation to use Ztiga first.Could you share your staging of PC at diagnosis and Gl score and subsequent treatment. I have exhausted chemo and Zytiga

HopingForTheBest1 profile image
HopingForTheBest1 in reply to immunity1

Question regarding your Lu177 treatments. As you may be aware it is not yet available here in the US except for clinical trials. Appreciate your thoughts about a trial combining Lu177 and Ac225? What side effects did you experience with Lu177?

immunity1 profile image
immunity1 in reply to HopingForTheBest1

Cannot give personal comments about the combination, check out Germany and Australia research.Re Lu177 alone in 2017 when I had only soft tissue lesions. Minimal clinical side effects with 4x treatments. Some elevated liver transaminase levels only. It probably has increased my survival by 1-2y;who knows. I have had 2 additional Lu177 treatments in 2020 which may have been less effective because of skeletal PC - pelvis, spine.

Comment: Treat early.

Magnus1964 profile image
Magnus1964 in reply to immunity1

I was diagnosed with a Gleason score of 9 and PSA of 39. I was found to be stage 4 so prostatectomy was not advised. I had an orchiectomy. A few years later my PSA stated to rise again I had external bean radiation. Then a few years after that I was placed on casodex. Casodex was effective for about 5 years.

My doctor then placed me on a clinical trial with Zytiga and prednisone. The trial was to get Zytiga approved for pre-chemotherapy patients. I was on that trial for 3 1/2 years until my PSA began to rise again.

I then had salvage radiation to my hip area. After that I had Provenge for some nodules in my lungs.

My doctor then put me on another trail with xtandi and a mystery drug from Eli Lilly. I lasted on that trial for 4 years.

immunity1 profile image
immunity1 in reply to Magnus1964

Whew, and an voyage a bit like myself. But I am sure how much I can transfer to me. And the role of the the mystery drugs from Eli Lilly. ....

Thanks anyway, every bit of knowledge adds to the puzzle

GP24 profile image
GP24

There is a cross-resistance between Abiraterone and Enzalutamide. This causes Enzalutamide to work for about three months only when taken right after Abiraterone starts to fail. As Allan wrote, get Chemo now and take Xtandi after that.

Magnus is an exception.

tomtom9148 profile image
tomtom9148

I was on xtandi fot 2 years, then switched to Zytiga after it started to fail. I was only on Zytiga for 2 months before the PSA rose dramatically. My understanding is that when one fails, the other won’t succeed . However, like anything with this crazy disease, many of us have different reactions to the same treatments

docbulldog profile image
docbulldog in reply to tomtom9148

I’ve gone the round with Zytiga and Xtandi and then chemo infusions the last several years. I’m hoping my oncologist will let me go back and try Xtandi one more time since it was successful for about 2 1/2 years.

inHishand profile image
inHishand

My husband had good response but only for about 6 months (11/19-5/20). Same as your father. He had no chemo, so consider Tall Allen’s suggestion, especially, if he is in relatively good health other than his pc. God Speed in your pursuit of treatment.

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