Rising ALP and declining PSA

[jersy]

Hello. I am on Xtandi as last ditch effort after Zytiga and Pluvicto eventually failed. After starting I have declining PSA but dramatically rising ALP. Any thoughts on what this means? Thanks all.

[Tall_Allen]

It means your liver is stressed.

[jersy in reply to Tall_Allen]

Thank you, TA! I always look forward to your knowledgable replies. Is 230 ALP cause for alarm? Is this a reason to stop Xtandi? thank you!

[Tall_Allen in reply to jersy]

Some patients temporarily back off the full dose to allow the liver to get used to it.

[RCOG2000 in reply to Tall_Allen]

I had an excellent result with one enzalutemide per day rather than four so backing off may be a good plan

[Tinkudi in reply to Tall_Allen]

Can it also mean bone mets progressing ?

[Tall_Allen in reply to Tinkudi]

Unlikely with declining PSA.

[MoonRocket]

What is dramatically increasing ALP?Can you give numbers?

[jersy in reply to MoonRocket]

over 230

[MoonRocket in reply to jersy]

AST and ALT?

[jersy in reply to MoonRocket]

in normal range