Xtandi

[scooby0111]

Zyriga failed after eight months and starting xtandi. What can I expect for success and for how long? The list of side effects is scary. Any comments are welcome.

[Magnus1964]

Everyone responds differently meds. I got four years from xtandi.

[Hidden]

The side effects of Xtandi are generally a bit more than Zytiga, but I would be more concerned about whether it will work since there is cross-resistance between Zytiga and Xtandi. Switching from one anti-androgen to another generally doesn't work for long, if at all.

That coupled with what appears to be a fairly short time to castrate resistance (although that's an assumption on my part: I don't see your treatment history)

I do think chemotherapy is a better choice for your situation, possibly followed by Xtandi or another anti-androgen.

The CARD trial proved that sequencing in chemotherapy is superior than just switching between anti-androgens.

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

Something to discuss with your doctor.

[Tall_Allen]

Better to do chemo in between.

[GP24]

Your doctor prescribed Xtandi because he thinks you will probably try to avoid a chemo. As Gregg wrote, there is a cross-resistance between Zytiga and Xtandi. Therefore Xtandi after Zytiga will work for two to three months only.

[Hidden in reply to GP24]

"Your doctor prescribed Xtandi because he thinks you will probably try to avoid a chemo."

I agree. I'm guessing it's because of the resistance to chemo and most people are fine with just taking a different pill.

I have one of these doctors, but I don't see her. She told me "I put everyone on Xtandi after Zytiga." Fortunately for me, I have another doctor at the VA who says "When Zytiga becomes ineffective, I won't put you on Xtandi because it's unlikely to work for long. You should do Cabazitaxel next." That's the doctor I'm using now.

[Hidden]

My husband was on Zytiga for about 15 months then switched to Xtandi and got almost 2 years of benefit. PSA was going up for the last 12 months on Xtandi but it was still doing "something". It really depends on the person and how they respond.He is now back on Xtandi after 10 months of BAT. (Also successful for psa reduction but especially for quality of life.) We hope this second time around is as successful as the first although I have to say, one week of Xtandi and he's back in bed at 8 and fatigued all day.

[julyturqsee in reply to Hidden]

what is BAT?

[Hidden in reply to julyturqsee]

Bipolar androgen therapy, also known as high dose testosterone. The treatment cycles through high and low levels of testosterone every 28 days.

[julyturqsee in reply to Hidden]

thanks for your reply. Can u explain BAT in more detail.? Is it like Estrogen Hormone Replacement? Does it counter ADT? never heard of it

[Hidden in reply to julyturqsee]

It isn't a common therapy because testosterone was thought for decades to fuel cancer. Many doctors won't do it even though the numbers of men who have tried it are increasinging and the trial doctors believe it is safe. Here is a link with some details (cancertherapyadvisor.com/ho.... You can discuss it with your doctor to see if 1. you are a candidate and 2. if your doctor is on board to try it.

[julyturqsee in reply to Hidden]

thank you. will read up on it.

[larry_dammit]

I started Xtandi after chemo ,Dec of 16. Not sure of all the side effects as I’m on ADT as well. Just watch out when starting new drugs. It does not play well with others.

[j-o-h-n]

Side effects should be called SuicSide effects....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/03/2021 6:52 PM DST