Could we switch to Zytiga now to make... - Advanced Prostate...

Advanced Prostate Cancer

20,785 members25,895 posts

Could we switch to Zytiga now to make hormone therapy work longer?

TN1932 profile image
18 Replies

I've read the article that Tall_Allen included in one of the posts: prostatecancer.news/2019/12...

"After cross-over, PSA was reduced by more than 30% in 36% of those who had Xtandi-second vs only in 4% of those who had Zytiga-second"

If I had known about this info earlier, we would have gone with Zytiga first instead of Xtandi. Will it help to switch to Zytiga now? My father is at 3 years point, which is the average time many progress to hormone resistance. I have been reading to get an idea of what he can do after Xtandi. There're several options but I have doubt that they are suitable for a 90 years old.

Written by
TN1932 profile image
TN1932
To view profiles and participate in discussions please or .
Read more about...
18 Replies
Tall_Allen profile image
Tall_Allen

BAT, an experimental therapy, has some success in extending the usefulness of Xtandi. A doctor at Johns Hopkins may be willing to treat him per protocol.

pubmed.ncbi.nlm.nih.gov/326...

Or, if his doctor is willing, try combining Zytiga+Erleada after Xtandi fails:

thelancet.com/article/S1470...

TN1932 profile image
TN1932 in reply to Tall_Allen

Thank you TA for your quick response. I'll take time to go thru the info you provided. So there's no point to do any change now, is there? BAT is the top option on my mind after doing some researches. I couldn't find any doctor specializes in BAT in Southern California. Hopefully, the doctor at Johns Hopkins allows telephone or over the web appointment. Very excited about the second option you mentioned. You have no idea how gratefull I am to have you with your immense knowlege on this forum.

Tall_Allen profile image
Tall_Allen in reply to TN1932

There are some probably unconstitutional laws about out-of-state telemedicine in many states. It may be a good idea when calling Johns Hopkins to lie and say you are visiting Maryland. They won't check your ISP.

podsart profile image
podsart in reply to Tall_Allen

what about Daralutamide?

Tall_Allen profile image
Tall_Allen in reply to podsart

No such data for darolutamide.

TN1932 profile image
TN1932 in reply to Tall_Allen

I'm sure you've seen this: ncbi.nlm.nih.gov/pmc/articl...

"The second-generation antiandrogen, enzalutamide, demonstrated full or partial activation of eight mutant variants, while the structurally distinct and most recently approved darolutamide demonstrated significant activation in only one mutant at concentrations up to 25 µM [21], which identifies a sequencing opportunity for this drug in men with progressive CRPC with a gain-of-function mutation in the AR under selective pressure of first-line ARPIs."

Does it mean Darolutamide can be tried after Xtandi? or is it better to replace Xtandi with Darolutamide before becoming resistant?

Tall_Allen profile image
Tall_Allen in reply to TN1932

Actually, I ignore lab studies like that for the most part,. They are useless for patients. Only clinical data has meaning for patients.

podsart profile image
podsart in reply to Tall_Allen

thanks

Tall_Allen profile image
Tall_Allen

Or just say you are in NJ - they won't check your ISP. It's a stupid law, and is probably unconstitutional (because of the commerce clause) if it is ever challenged.

Gl448 profile image
Gl448

Changing your ip is one of the best reasons to use a VPN. Just select a server in the location you’re lying about being from.

Gl448 profile image
Gl448

My reply was meant to be more for the general audience than you. Many people don’t have a second home in Jersey that allows them to just go there to be within the service sphere of whatever doctor they’re trying to conduct business with.

EXPRESSVPN worked with Netflix last time I tried it, but it’s been a while since I tried.

Gl448 profile image
Gl448

They could always ask you how to do it. 😉

Or just use Google, it’s not rocket science, they were able to find this site after all. Most VPNs are just plug and play by downloading an app, and will work for most situations where they’re not trying to rip off a movie streaming service.

Seems silly to outright dismiss it as an option because you aren’t sure users here can figure it out.

Gl448 profile image
Gl448

Cool.

Tall_Allen profile image
Tall_Allen

The gatekeepers are usually people with little technical expertise or initiative to check ISP. They only ask because it says to ask on some form they were given. Patients don't care and doctors don't care if it is in state.

Tall_Allen profile image
Tall_Allen

Coincidentally, it was a doctor at MSK who thought it was a good idea to just lie about it. All parties benefit, so who would sue? That's been the problem in challenging the law- only those in-state who are harmed by it have standing. He shared this legal brief with me:

scholarlycommons.law.case.e...

Tall_Allen profile image
Tall_Allen

But who would enforce or challenge that? The state would never know. No one in any state gov't agency monitors telemedicine calls. Doctors make money, so there is nothing to motivate them to find out if the patient is in state. What would they do, report themselves? Patients are the ones seeking the visit, so they would never report it.

Tall_Allen profile image
Tall_Allen

How would the insurer know? They can't monitor calls either. All insurance allows for coverage of medical services when traveling out-of-state.

anony2020 profile image
anony2020

Not sure about that. If you do have the disease, and you do get treatment for it. Lawyers may get a few $$ for the fight. But is it worth it?

You may also like...

Zytiga no longer working, moving on to Enzalutamide.

Hi everyone, after four months on Zytiga, my Dad's PSA went back up. Due to the coronavirus the...

Hormone therapy can make prostate cancer worse, study finds

but I think it is very very interesting for those who haven't seen it. https://www.sciencedaily.co

Does Viagra work when your on Hormonal Therapy

said it would not. Has anyone tried this while on Hormonal Therapy?

Rechallenge with Xtandi

decided to give Xtandi a second chance. I had taken Xtandi back in 2015-2016 after Zytiga failed...

Question about OS statistics for stage 4 prostate cancer

the patients in those statistics did not have second line ADT treatments Zytiga and Xtandi...