Advice please..Zytiga failed

[Prayersforallofus]

Hi everyone. Just joined. Have stage 4 castration resistant metastatic prostate cancer that has spread to many bones. Diagnosed 5 1/2 years ago... had Docataxel chemo, then lupron/Casodex....had to drop Casodex and change to Zytiga with Lupron....now that's failing...just started Orgovyx and awaiting Earleda to be approved....anyone else in this situation? Advice? Hate to do chemo again but worried since PSA 183 and ALP very high...I'd appreciate it 🙏

[Tall_Allen]

Good idea to do Jevtana as your third medication:

prostatecancer.news/2019/12...

Or Xofigo:

prostatecancer.news/2021/02...

Or one of the radiopharmaceutical trials targeting PSMA:

prostatecancer.news/2020/08...

It's even better than Jevtana:

prostatecancer.news/2020/05...

Provenge is a also a good idea coupled with chemo or radiopharmaceuticals.

[Prayersforallofus in reply to Tall_Allen]

Thanks for your help!

[Hidden]

I would go to second-line Jevtana (Cabazitaxel) rather than switching to another anti-androgen drug such as Xtandi. Better results have been proven by alternating chemotherapy with anti-androgens.

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

Cabazitaxel is more easily tolerated than Docetaxel for most, especially if the dose is 20mg vs 25mg per square meter of body surface area. The results are just as good with less side effects.

ascopost.com/issues/decembe...

[Prayersforallofus in reply to Hidden]

Thanks so much🙏

[Faith1111]

I would get DNA testing for gene mutations. Foundation One does it. It will help identify mutations that may respond to immunotherapy. You may be a candidate for keytruda or other meds. Worth knowing

[TeleGuy]

Did you try switching from prednisone to dexamethasone?

[Realistic]

God bless, really hope you get the right treatment for you. Sending love to you all SheilaFxxx