Intermittent secondary ADT

[Javelin18]

I'm currently taking Xtandi while waiting to start a CAR-T trial. Due to the way scheduling is working out, I'm starting and stopping Xtandi three times. It occurs to me that this might have a benefit similar to Bipolar Androgen Therapy, where it might delay resistance to Xtandi and kill more of the cancer.

Does anyone know if intermittent second generation androgen drug use has been tested?

[cesces]

Intermittent has been an acceptable protocol for some time.

But more like 18 months on, then wait for PSA to rise back up.

[Javelin18 in reply to cesces]

Thanks.

After one week on my PSA went from 279 to 231, my pain went away and my mobility got better. Unfortunately I had bad side effects that took a week to diagnose. I'm back on for four days, then off for a week prior to leukopheresis. After that I'm on for two weeks before stopping prior to reinjecting the T cells.

I'll see how the cancer reacts to short cycling. It seems that hitting the cancer, then letting off on s short cycle might kill cells that would otherwise become dormant.

[Oldie68]

Is there any evidence, other than anecdotal, that intermittent ADT works? Any clinical trials? Is the protocol for metastatic PCa?

[Javelin18 in reply to Oldie68]

Not that I'm aware of, but others may have information. My intermittent use is driven by external factors. I think what I'm having to do may be different than what may have been studied. I'm continuing Lupron and only intermittently discontinuing Xtandi.

[CAMPSOUPS]

Interesting thought. Your right that it seems all adt bat treatments by individuals have been "on and off lupron/eligard" not with a 2nd generation like Xtandi or Zytiga. I guess you are still on lupron/eligard thru-out this time period?RSH1 I guess has flooded my brain with too much info. If I remember he is doing bat and is using Zytiga but actually I cant speak to that really without going thru his posts.

Regardless I hope this has an advantage for you and I look forward to when you can start the car-t trial (May 18th?) you deserve a break from progression.

[Tall_Allen]

BAT alternates ADT (no testosterone) with high testosterone.

Starting and stopping Xtandi may select for resistant cancers. It is never used that way. Continuous ADT+Xtandi kills more of the cancer and delays resistance.

[Javelin18 in reply to Tall_Allen]

Selecting for resistant strains makes sense to me as an analogy to bacterial resistance to antibiotics. It also makes me wonder how BAT works. Why does it delay rather than select for resistance?

[Tall_Allen in reply to Javelin18]

Here's an explanation:

prostatecancer.news/2016/09...