Zytiga vs Xtandi

[TnRebel62]

November of 2020 PSA was noted at 4.5. 6 months later it was 32 then quickly up to 46. Biopsy graded out at GL9. PSMA found metastasis on the sacrum and multiple lymph nodes in pelvic and abdominal area. Started Lupron in October and radiation therapy in January 2022.

One oncologist likes Zytiga over Xtandi and the other one likes Xtandi over Zytiga. I do have HBP, currently well controlled avg 117/74 and diabetes 2, recently dropped A1C from 8.4 to 6.6 with diet & exercise + metformin 500 twice a day. History of arrhythmia/AFib with mother and uncle.

Thoughts and advice as I go into my next round of appts and make a decision on which one to add to the Lupron?

[Tall_Allen]

Or Erleada. Or triplet therapy.

If they insist on those 2 choices, the sequence of Zytiga->Xtandi last longer than Xtandi->Zytiga.

thelancet.com/action/showPd...

[TnRebel62 in reply to Tall_Allen]

Thank you, definitely what I am looking for, more info in order to ask better questions with my MOs

[RyderLake2]

Hello, You are talking the Pepsi and Coke of second line anti androgen drugs for PCa. Each one has its advocates and each one has its detractors. To make things even more complicated, everyone is different. For me, the big issue was the prednisone that goes along with Zytiga (abiraterone) so I went with Xtandi (enzalutamide). I have been on it since September, 2017. Touch wood it is still working after four and a half years. As I said everyone is different! Good luck with your choice. 😊

[j-o-h-n]

To ElevenSee Reb,

Would you please be kind enough to tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/22/2022 6:46 PM EST

[Hidden]

I've seen this monster movie...I won't be a spoiler.

[TnRebel62 in reply to Hidden]

I feel like this is one of those movies where you are never quite sure what the next plot twist is going to be. 😆

[Grumpyswife]

I regret not doing Zytiga first. Side effects of Xtandi were harsh so my husband could never tolerate a full dose which defeats the purpose. It seemed to take a permanent toll on him.

[Roscoaus2000]

I started on Enzalutamide after Casodex failed after 12 months(it was excellent brought psa from 9000 to<0.01 in 4 months) I loved enjoying made me full of energy and dropped psa back to<0.001. However after 4 months I had a minor seizure-5 hours memory loss. Cautions indicated this could occur. Onc. Immediately changed me to Zytiga + Prednisolone 2 x 5mg. Took me 3 weeks to accept this but it has now worked for 4 years, albeit in last 12 months psa has slowly risen to 0.16. The point of this story is that irrespective of theoretical advantages of one over the other your body will determine which is the best for you.

[2dee]

In MY case Xtandi really dropped PSA for 15mos. Limited side effects, mostly fatigue and some brain fog.Now on Lynparza for 4 mos really working great on everything except PSA which has climbed from teens to 40s.

2Dee

[XrayDir]

I was on Xtandi as my first treatment and it supposedly stopped working after 3 months (scans showed “more growth”.) I have been on a couple of chemo treatments and they have supposedly failed too. I just changed to a new MO to get on a clinical trial and he is recommending a combo of Zytiga & Xtandi as a “bridge treatment” until I get on the trial. He said he has had very good results with this combo. Maybe you could check with your MO to see if the combo would be an option. If you need more info , let me know and I can get you his contact. Best wishes for you in your journey.

[TnRebel62 in reply to XrayDir]

Hadn’t thought of that, thank you.

[BillyJack25]

I was on Lupron for 2 years which kept my PSA low. After 2 years PSA began to rise. OC put me on Erleada at 4 pills per day (240 mg). PSA dropped immediately but side effects were unacceptable, extreme fatigue, migraine headaches, low-grade headaches all the time, etc. OC reduced my dose to 1 pill (60 mg) per day and after only one month of 1 pill/day I am feeling much better and my PSA went down another .1 to .41.

[TnRebel62 in reply to BillyJack25]

That seems to be a recurring theme- starting at the high regular dosage and then it being cut back to a dose that seems to maintain just as well

[TnRebel62]

Went with the Xtandi, one week in and all seems good. PSA was .3 before I started so we will see where that goes.