Can I try A rechallenge with Xtandi after using docetaxel and cabazitaxel?

[Peterd110]

I Used xtandi before in a trial. Ended trial when psa started increasing some. Since then have failed docetaxel and now cabazitaxel/carboplatin. Planning on xofigo next but my hemoglobin has been in the 8’s since beginning chemo. Could retrying xtandi benefit me at all while I wait for my hemoglobin to recover ?

[tango65]

Sometimes chemo could re sensitize the cancer to anti androgens which failed before.

[noirhole]

With your hemoglobin in the 8s are you tired and feel exhausted when preforming activities?

[Peterd110 in reply to noirhole]

Not really. I get tired sometimes, but nothing unusual.

[noirhole in reply to Peterd110]

Mine is in the 8s and it exhausts me walking or going up the stairs. Can't catch my breath.

[Tall_Allen]

Why not try and see?

[RJ-MN]

I'm in a similar boat, Peter, with PSA going up 18+ after my last (#7) dosing of cabazitaxel. From 2014-2019 I had a life-saving run on a clinical trial @ the NIH using enzalutamide plus Prostvac-Tricom. At progression I returned to Mayo and quickly cycled through Abiraterone, Docetaxel, Docetaxel+Caboplatin, Radium223, and now Cabazitaxel. I'm trying to stay alive until I can try Lu177 (in this country, can't afford going overseas), although I don't know for sure that I'm PSMA-avid. Trying to eek out a few extra months of suppression, I'd LOVE to rechallenge with Enz, but it isn't in Mayo's "Protocol". (!)

[MateoBeach in reply to RJ-MN]

Ask them (insist) that they try a re-challenge with enzalutamide since chemo has been shown to sometimes restore sensitivity to AR drugs. Abiraterone re challenge also an option, or apalutamide. You need treatment personalized and not a protocol. I would not accept that.

[Kevinski65 in reply to RJ-MN]

I'm in that trial. Been in it for 7 years. I got in the , 'Xtandi only' arm. NIH still wants me to take Lupron though. They told me the prostvac arm was closed down because there was little evidence it worked with Xtandi. So I got 2.5 years on Lupron and 7 on Xtandi and still 0.4 psa. NIH continues supplying the Xtandi. I don't think I could afford Xtandi unless it was given too me. Good luck?

[RJ-MN in reply to Kevinski65]

Sincere congratulations, Kevin, on your longevity on this trial. Did Covid keep you from the NIH for a while? Are you now visiting there every 6 weeks? Please tell Ravi & Sherri hello from Ron in Minnesota. I miss them!

[Kevinski65 in reply to RJ-MN]

Yes I will. Sherri is a sweetheart. They've all been nice to me. For a while they mailed me Xtandi and I got the blood tests from my local oncologist and had them faxed to NIH. I just started going back every 12 weeks. They stopped doing pet , cat and bone scans because I've been 0.04 for so long. Before getting into the trial , I was a supplement freak. I also took the maximum aspirin. I was told to stop all that particularly the aspirin. Since then, they've loosened up on supplements but just want to know what you're taking. I take zyflamend now and drink 🍷 pomegranate juice. I have had a long ride on Xtandi and Lupron. Good Luck to you.

[lcfcpolo]

Yes, please do but do caveat that it should be used alongside Standard Of Care not instead of. If there is any supporting research for your herbs, then please post as well. Background to your original diagnosis such as PSA, any mutations, where spread of Mets were before and after also help people to make an informed decision. I look forwards to reading...

[docbulldog]

I towould like to go back and try Xtandi again. I failed Docetaxel after 10 infusions and psa at 60. I took a break for 3 weeks and have just finished my second infusion of Cabazitaxel. My psa did not drop following 1st infusion and tested at 100. I will have a blood draw on the 07/05 before the next infusion. I am a bit concerned, but with no out of the ordinary pain my OC wants me to continue Cabazitaxel. We are waiting for PS MA and LU-177 to be available near our SE Washington location.

So why not go back to Xtandi which I had success with 4 yrs ago. I agree with you.