Mr. Spouse21 has been on Xgeva for nearly two years. What's the latest research on getting the most optimal benefit from it without staying on it too long? He does have some side effects of weird aches and pains for around a week after he gets the monthly shot. His local oncologist talked about getting more infrequent shots but we can't find any research on this approach. Anybody more updated on Xgeva than we are? Thanks.
P.S. I updated Mr. Spouse21's profile, which shows continued stability post-Docetaxel, which ended in May, 2020, a year and a half ago when he got his 10th infusion. So he's gotten decent mileage from chemo so far.
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The less intensive regimen using the same drug, denosumab, is called Prolia. It is 60 mg only every six months. After initial period with Xgeva, it would seem to be appropriate to switch to Prolia for ongoing maintenance, unless there is some reason to do otherwise.
It is a good point, Scott. 12 X total higher dose over a year. Xgeva is indicated for cancers with metastasis to bones, whereas Prolia just for osteopenia / porosis. So for bone protection and for metastasis prevention it is not clear. Xgeva probably to be sure. And it can be self (or wife) administered at home. I’m going to ask my MO in January about increasing my dose, perhaps 120 mg (Xgeva) every three months?Among the several benefits of melatonin in prostate cancer, protecting against bone metastasis by the similar mechanism (RANKL inhibition) is among them. I am going to resume nightly melatonin.
Both appear to be beneficial. Denosumab is more powerful bone protector via RANKL inhibition. But melatonin seems to have multiple mechanisms of possibly benefiting in PC. So I choose both, at least Prolia, perhaps Xgeva and also melatonin at bed time at least a few nights per week. I want it all on my side.
There is accumulated evidence that melatonin will be a favorable component during PC treatment by multiple mechanisms. Easy to find that research and come to that conclusion. And yes it is clearly safe across a broad range of dosages. But the dosage for helping fight PC is not clear. Many sources mention 10 to 20 mg nightly which seems reasonable (vs 3 mg often advised for insomnia). We cannot expect prompt change in PSA from starting or stopping it. So it is partly a matter of faith that there will be some benefit over time and very low risk. I take breaks from it at , times as it can cause me weird nightmares. At present I use 10 mg for no particular reason other than I am comfortable with that. Just a personal choice given the uncertainty. Paul
I get Xgeva 120 mg injection every 12 weeks. Had a Dexa scan and a dental check up before starting. Been on it 14 months. Started 2 months after starting ADT with Firmagon, and 1 month after Dexa scan. Taking lots of calcium and Vit D.No side effects from Xgeva shot under back side of left arm near shoulder.
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