Is Xtandi Failing?

[GTTown]

Background:

Diagnosis in Jan/2020, PSA 577, Gleason 9, mets to lymph nodes and bones

Started Firmagon immediately as well as chemo, 6 cycles of Docetaxel.

Followed this by radiation to the prostate.

PSA dropped pretty quick and eventually into the teens and single digits, lowest was 4.5 back in January (with the occasional blip).

However, it April, it increased to 9.5 so my Dr put me on Xtandi. One month later it dropped to 3.5, however, another 3 months later, it is at 7.5.

I see my Dr in a few weeks (on vacation) and getting some CT scans ordered by the fellow.

Any thoughts?

Does this mean Xtandi is failing?

What's next?

[FionaElbourne]

My husband has had the same treatment as you, he got 14 months before Xtandi failed. He then went onto 6 sessions of Radium 223 but unfortunately the PSA didn’t reduce but stayed stable. After that it was 10 sessions of cabitaxel chemo which slightly reduced the PSA but it immediately rose when chemo finished. He is now on Pluvicto he has had 3 so far. The PSA is coming down but heavy impact on bloods and liver and very u sure whether he will be able to have any more. He was diagnosed in March 2015

[GTTown in reply to FionaElbourne]

Thanks for your response and hoping for the best for your husband.

[16starsky in reply to FionaElbourne]

Hi Fiona,

Noticed that you are from the UK, may I ask are you doing Pluvicto privately, and if so where.

My Husbands Abi is now failing, so cabitaxel is our next step, apparently. Looking ahead at Pluvicto ourselves.

Sorry to hijack this post.

[FionaElbourne in reply to 16starsky]

Yes we are in Scotland but go to the Wellington Hospital in London and pay privately. We were hoping that after 3 treatments the NHS may have approved it but not looking likely.

[16starsky in reply to FionaElbourne]

Thankyou, why on earth cant they just approve it for all the men that need it, makes my blood boil!!!!

[FionaElbourne in reply to 16starsky]

Me too, it can help extend lives and only those that can afford to pay or have insurance get the chance to try it.

[Tall_Allen]

A recent PRESIDE trial found that combining enzalutamide with docetaxel was able to extend its effectiveness:

prostatecancer.news/2022/10...

[GTTown in reply to Tall_Allen]

even though I had docetaxel three years ago?

[Tall_Allen in reply to GTTown]

Unless it stopped working.

[GTTown in reply to Tall_Allen]

If in fact Xtandi is not working, would switching to Zytiga be an option as well?

[Tall_Allen in reply to GTTown]

What I recommend is better.