TA Stampede Trial Q: Hey Tall guy... - Advanced Prostate...

Advanced Prostate Cancer

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TA Stampede Trial Q

15 Replies

Hey Tall guy

When "3 years of ADT and 2 years of abiraterone is standard-of-care"

How is that timed?

Start ADT and Abi together, and stop Abi at 2 years leaving ADT by itself for the last year?

How would that work in my case?

I started ADT and Abi at the same time, then RT after 6 months.

My MO quoted following the STAMPEDE protocol, but stated lifetime ADT.Abi

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15 Replies
Tall_Allen profile image
Tall_Allen

"Start ADT and Abi together, and stop Abi at 2 years leaving ADT by itself for the last year?"

Yes. Having RT doesn't change that, and is part of the STAMPEDE protocol.

in reply toTall_Allen

Hmmm, 1 more year Abi, 2 more Lupron!!!😃

Hey, I need to know if it was worth suffering through 7 weeks of pelvic/LN radiation.

As if ABI/ADT isn't enough suffering.😬

EmpireGradeCyclist profile image
EmpireGradeCyclist in reply toTall_Allen

This is interesting. I’m T3N1 (Grade Group 5/G9) and my oncologist just had me stop ADT and Abi at the two year mark. I also had EBRT and a brachytherapy on the front end. Should I be concerned and ask for another year of ADT?

chefjlu profile image
chefjlu in reply toEmpireGradeCyclist

I am T3aPN1, Gleason 9 also, prostatectomy - no treatment for almost 3 years with PSA undetectable - then slight rise, PET scan, 1 spot seen, started Abi and Lupron, 8 weeks radiation - just past 1 year mark on ADT & Abi and told will be pulled from both at 2 year point, then monitoring -- my response to treatment has been very good, little side effects, PSA undetectable, no issues with liver and such. Decision concurred with Roswell Park and NYU consultation. Know several other men with similar.

EmpireGradeCyclist profile image
EmpireGradeCyclist in reply tochefjlu

Thanks for the report and glad you’re doing well with the protocol.

In my case I went straight to the ADT and Rad - two different surgeons at NCI centers deemed my prostate too involved with cancer to attempt a prostatectomy. After Dx went straight to starting ADT and my PSA went from 34 to 1, then with Rad it has has been undetectable for about 18 months. I wish I had limited side effects but that’s probably a combo of ADT and Rad, and I found it hard to keep up exercise during treatment. Now I’m paying for that (weight gain and man boobs ugh).

chefjlu profile image
chefjlu in reply toEmpireGradeCyclist

Understand completely, the journey is as varied as each of our actual diagnosis. Continued prayers and good thoughts to you!

AMIN25 profile image
AMIN25 in reply toEmpireGradeCyclist

The reason for taking a break from ADT if your PCs is in control is to stop long term effects from continuous ADT - including cognitive and cardiovasular progression

Tall_Allen profile image
Tall_Allen in reply toEmpireGradeCyclist

That's the only info we have so far. There is a new trial that uses 2 years of ADT ± 2 years of Erleada in N1 recurrent patients.

garyjp9 profile image
garyjp9 in reply toTall_Allen

TA, I am in year 3 of the STAMPEDE protocol for N1 disease. I had a 3.5 PSA post-surgery in 2020 but became undetectable soon after starting ADT and ABI. At time of surgery, I had negative bone and axumin scans but no scans of any kind since. My MO says no scans are needed because of undetectable PSA; I would like a scan before the end of year 3 to rule out any non-PSA producing cancer. Is this a reasonable request? If so, what scan should I be asking for?

Tall_Allen profile image
Tall_Allen in reply togaryjp9

Non-PSA-producing PCa is extremely rare, especially at your (early) stage. Maybe an FDG PET scan would help make you less anxious?

garyjp9 profile image
garyjp9 in reply toTall_Allen

Thank you, TA

garyjp9 profile image
garyjp9 in reply togaryjp9

Would an MRI be as revealing of any non-PSA as an FDG-PET?

Tall_Allen profile image
Tall_Allen in reply togaryjp9

The only use of an MRI (or CT) is to locate a correlate of something seen on a PET scan.

garyjp9 profile image
garyjp9 in reply toTall_Allen

Thank you

garyjp9 profile image
garyjp9 in reply toEmpireGradeCyclist

I was in a similar situation. My MO suggested I stop both ADT and ABI after 2 years. Of course, I wanted to do so, but I have been following TA's posts about the various trials and protocols on this. I elected to do the third year of ADT in conformance with STAMPEDE. My MO had no objection to that.

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