Enzalutamide vs Aberaterone

[Farn]

Which is best to offer the most longevity ?

An often mooted question, but from my studies there seems to be more longevity with the Aberaterone with the longest period I’ve read about being 10 years and still going

This example is Alfred Samuels where as Enzalutamide the longest I’ve heard of is 4years

[Magnus1964]

My research doctor told me the average efficacy for both is measured in months. I got 3 1/2 years out abiratorone and 4 years out of xtandi. Everyone responds differently to treatments.

[Farn in reply to Magnus1964]

That really is impressive

[Kevinski65 in reply to Magnus1964]

What r u taking now, of u don't me asking?

[Magnus1964 in reply to Kevinski65]

After xtandi fail in January 2020 I am on no treatments. I have run out of options. Time for some off market treatment.

[pjoshea13]

You can't use outliers to build a case.

When Abi & Enza were new it was a useful question for those following androgen receptor [AR]-axis monotherapy (with or without classic ADT). Or to ask which sequence gave best survival. But with the options now available, we need to consider combination, not just sequences.

And if there is a place for bipolar androgen therapy (BAT). Note the TRANSFORMER trial:

pubmed.ncbi.nlm.nih.gov/336...

-Patrick

[Farn in reply to pjoshea13]

Thank you

[Tall_Allen]

We don't yet have randomized trial data. But a retrospective trial of the VA database found that enza was more effective than abi as a first therapy, but after using the other drug, there was no survival advantage to either sequence:

ncbi.nlm.nih.gov/labs/pmc/a...

However, abi->enza had more progression-free time vs enza->abi:

thelancet.com/action/showPd...

[mrscruffy]

6 years in June, Aberaterone

[Farn]

Thank you so nobody suggesting more than 4 years on Enzalutamide

[Shooter1]

I'm at the 4 year pt. now with BCR in ribs and ischial tuberosity. Still on xtandi but it doesn't stop all the new mutations. Best of luck to you.

[Farn in reply to Shooter1]

Thank you

[Foldem]

I started Xtandi in 2012 and didn’t become resistant until 2021. Switched to Zytiga/Prednisone for a few months without results. Just had my first injection of Xofigo (radium 223). I sense that most do Zytiga first, than Xtandi. (Zytiga is a lot less expensive too)

[EdBar]

I’ve been taking Xtandi for nearly 7 years now, about a year ago my undetectable PSA using an ultra sensitive test has become detectable although it would still be undetectable on a regular PSA test.

Ed

[Farn in reply to EdBar]

That’s encouraging I know everybody is different but it’s good to hear about long term success

[Miccoman]

I was on Xtandi from 2016 to 2021. I dropped my PSA down below 1.0 very quickly. It wasn't until 2020 that it went above 1.0 and was at 2.3 when I stopped for Provenge last year. I started Xtandi again when my PSA started rising and it helped initially, but now it doesn't seem to be stopping disease progression -- PSA now at 7.43 and I have to decide what to do next month when I see my MO.

[Farn in reply to Miccoman]

Thank you for sharing and I wish you continued success with your next chosen treatment

[Kevinski65]

I've been on enzalutimide since 2015

[Farn in reply to Kevinski65]

Thank you for sharing great to hear