Is Zytiga a good choice after Xtandi fails?

[Toyota_PU]

Is Zytiga a good choice after xtandi fails, or is there a better route available?

[Hidden]

Second line chemo then Zytiga.

[Tall_Allen]

I think it's best to alternate chemo and hormonals.

[Dalph87]

Add chemo first then try Zytiga, you might be lucky and it will work, sometimes chemotherapy can make the hormones effective again.

[Hidden]

It's better to go with chemo, then back to another anti-androgen like Zytiga after chemotherapy. This has been proven in clinical trials. Here's info for one of the trials:

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

[cesces]

"do not believe you will need a full course"

That's interesting.

What do you mean by not a full course?

[cesces]

I seem to recollect that someone posted a study here about the proper order of these two.

I

[Magnus1964]

Yes, they are both hormonal ablation treatments but work in different ways.

[cesanon]

What would be a reasonable course to knock out the AR-V7 variant?

1, 2, 4, or ??

[cesces]

Yeah. Makes sense. Each chemo followed by a test, until you get where you need.

[dpnick]

Xtandi worked for me for about a year. then numbers went up again, now on zytiga and predistone relatively stable..... have a CT scan next week...... then we'll see!

[Spyder54]

Xtandi failed me right off. Allowed T to go from <3 to 16, then 24 (PSA followed about 2 weeks after T) Switched to Zytiga/10mg pred w Lupron and T went back to <3 and PSA went 5.4, 4.6, 3.4,2.2(June 2021). New Onco this week. Will see what is next (think I know). Guess is 6 Docetaxel but time will tell. Prostate still untouched which has never been my wish, especially at almost 9 months. Mike

St Pete

[Nickhmcg in reply to Spyder54]

Spyder54 can i ask how you are doing with the Zytiga?

[Spyder54 in reply to Nickhmcg]

Yes, by the numbers: very good. The effects of low labido, loss of muscle, fatigue, hot flashes, a little brain fog, all part of the drill. Remember, we are trying to LIVE here. PSA from 47 down to .67 over 11 months. Still have prostate in place (inoperable) plus on Lupron 3 month injects.

[Nickhmcg in reply to Spyder54]

Thanks Spyder54, my Dad is currently on a trial Xtandi & radium 223 with zometa, I'm just looking ahead I wasn't sure if you could do Zytiga after xtandi. He is doing well symptom wise, oxycontin and oxynorm are used for pain. Last psa shows increase in psa but we won't know if its disease progression or treatment flare until after scans next week 🤞🤞🤞🤞🤞🤞

[Spyder54 in reply to Nickhmcg]

In my case it was an excellent transition. We have to remember that every man presents differently, and it seems each man has slightly different (although similar) chemistry. Some of the pain, if in bone, may be negated w Sterotactic Radiation Therapy (SABR/SBRT). Others here have been fortunate to locate trouble through a PSMA Scan, then zap it. Mike

[Nickhmcg in reply to Spyder54]

Thanks Mike, he has had spot radiation to both hips and shoulder which helped hugely. Thank you for replying