Enzalutamide approved for patients with high risk of metastasis

[Maxone73]

onclive.com/view/fda-approv...

[PCaWarrior]

Clinical trial: Phase III trial of an adaptive therapy with excellent results. AUA 2023: EMBARK: A Phase 3 Randomized Study of Enzalutamide or Placebo Plus Leuprolide Acetate and Enzalutamide Monotherapy in High-Risk Biochemically Recurrent Prostate Cancer

urotoday.com/conference-hig...

[KocoPr]

Excellent bit I would like to see how darolutamide/Orgovyx with same criteria

[MoonRocket]

I just added Xtandi to my treatment due to this trial. Starting out with 80mgs a day...will move to 160 at my next appointment. Hoping to get to < .2 and then off treatment until 2.0. Another PSMA scan between 1 and 2 to find the bastards..last PSMA scan found zilch.

[Hidden in reply to MoonRocket]

I discussed this with my MO just days ago.

The trial was meant for initial use of Xtandi for nonmetastatic castration-sensitive prostate cancer.

If you're metastatic, you start with Zytiga, then got to Xtandi when becoming castration-resistant.

[MoonRocket in reply to Hidden]

Do you not think my MO and I know this?

And what do you infer from negative PSMA scans? That I'm metastatic?

[Hidden in reply to MoonRocket]

Your bio shows you as 3TbN1MO. N1 is metastatic, albeit near, but still metastatic.

I am N1 now too, hence my MO saying I was metastatic, even N1 is considered metastatic, and do not fit in that trial.

[MoonRocket in reply to Hidden]

You're wrong, N1 is not metastatic and all of my clinical notes per my RO, MO and consulting MO indicate that I am non-metastatic. N1 is regional prostate cancer which is classified as non-metastatic.

I've been at this a bit longer than you...I know my status.

[Hidden in reply to MoonRocket]

Please calm down. Its not a pissing contest, but a friendly debate.

As far as my MO and RO one lymph node is metastatic, N meaning NEAR metastatic (oligometastatic ). For the purpose of the Xtandi FDA approval mentioned above, N1 is metastatic in their eyes. It'smeant for confined to the prostate.

So let me ask you , why Xtandi, and not returning to Zytiga?

[MoonRocket in reply to Hidden]

I'm calm...N does not stand Near...it stands for Nodes, specifically those in the pelvic region.Metastasis (M) describes whether the cancer has spread to a different part of the body.

Because I'm considered BCR...as I indicated in my original post..hence I'm adding xtandi.

[MoonRocket in reply to MoonRocket]

My consulting MO is the Director of Translational Research in Prostate Cancer at MSK

[Hidden in reply to MoonRocket]

Im BCR too. Went over 4 years after RP, with PSA undetectable.

At .4 my team (I dont drop names) decided to start with Zytiga, and WPRT with extended field lymph nodes. Saving the Xtandi in case I become resistant.

Im PSMA clear in one year, and <0.02 PSA but I'll have Xtandi, in case of another BCR due to resistance. Or maybe Its cured. Going to stay on Zytiga one more year.

[MoonRocket in reply to Hidden]

Technically, you need to exceed 0.2 to be considered BCR after RP. Why would you restart ADT + zytiga at .04? What clinical studies are you and "your team" following that indicates ADT + zytiga with WPRT at 0.04?

I would also add, xtandi after zytiga is not a guarantee. Many get zero time on xtandi or so few months it doesn't justify the saving.

[Hidden in reply to MoonRocket]

Typo 0.4

I didn't restart. No ADT after RP, I was N0M0 at the time

My bio has the right numbers

[MoonRocket in reply to Hidden]

Reading your bio you are intermediate risk...so you could possibly be cured...I'm Gleason 9 ( 4+5) with a somatic ATM mutation, I'm high risk and am looking into all avenues of treatments...which why I have the name dropping consulting MO... he's an expert in HRR mutations and is actively conducting clinical trials with PARP and ATR inhibitors.

[Hidden in reply to MoonRocket]

I stated with RP in 2018!! Ive been at this longer!!😜

[RJAMSG in reply to Hidden]

How long were you “<“ after the RP?

[Hidden in reply to RJAMSG]

First PSA test at 90 days.

[RJAMSG in reply to Hidden]

So after the 90 days the psa remained at very low levels “.0 something” but never had the < again

[Hidden in reply to RJAMSG]

Undetectable, was <0.1 for 4 years. Starting with the first PSA test at 90 days post op. Then every 3 months for a year, then yearly. 0.2 appeared at 51 months post op.

PSA tests were not ultra sensitive, as any salvage treatment would not be considered until 0.2 or greater. Treatment was started when reached 0.4

[MateoBeach in reply to MoonRocket]

Good plan, MoonRocket

[Plaxsis]

Ok, end of round 5. Go to your corners.

[Maxone73 in reply to Plaxsis]

😂😂

[London441]

Indeed. What seemed like the back and forth of an argument between 2 guys with the same pathology was an illusion! They can kiss and make up now.

[MoonRocket in reply to London441]

Jack Lalanne has appeared.

[London441 in reply to MoonRocket]

I've been called worse😀

[MoonRocket in reply to London441]

I was hoping for one of your fitness stories..oh well..

[j-o-h-n]

I call my sugar Xtandi....................... (enzalutamide)...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/20/2023 6:12 PM EST