Why do MO have one stop Zytiga and Prednisone during Cabazitaxel And Carboplatin treatment for pca Adenocarcinoma liver Mets?

[Shorehousejam]

I should have asked. But, we asked so many questions, plus hoping for a more detailed answer

[Tall_Allen]

There is no point continuing a medicine you are resistant to. But a recent trial suggests that switching to Xtandi with chemo may lengthen its usefulness. The PRESIDE trial wasn't exacly your situation, but it may be worth a discussion:

prostatecancer.news/2022/10...

[Shorehousejam in reply to Tall_Allen]

Wow, Thank you so much…I’m just nervous I’m on Firmagon only.

So, should I switch to or add Xtandi?

I had docetaxel in 2022 now I’m on cazabitaxel and carboplatin should I asked to switch from Firmagon to Xtandi?

Tall_Allen

[Tall_Allen in reply to Shorehousejam]

It is not exactly your situation. It is similar, but not the same. In the PRESIDE trial, patients failed Xtandi, while you have failed Zytiga. Also, they combined Xtandi with docetaxel, while you are getting cabazitaxel+carboplatin. You may want to email the following to your oncologist with a note that you would like to discuss if it can apply to your situation.

thelancet.com/journals/lano...

He may feel that cabazitaxel+carboplatin is enough, which is reasonable. I think you should hear him out - he has the experience.

[Shorehousejam in reply to Tall_Allen]

Right, I was wondering if he is trying to re sensitized me to Firmagon, and holding onto Xtandi for a next resort

I’m see him May 29th I’m definitely going to find out

Thank you

[Tall_Allen in reply to Shorehousejam]

Firmagon always "works" in that it always prevents testosterone production.

[Shorehousejam in reply to Tall_Allen]

Oh ok, now I understand thank you for the clarity,

[gsun in reply to Tall_Allen]

I thought they always kept you on ADT during chemo because the production of testosterone could speed up the cancer even when resistant.

[Tall_Allen in reply to gsun]

Yes, ADT is permanent in men with metastases.

[Shorehousejam in reply to Tall_Allen]

 Tall_Allen wondering if you saw below, I’m concerned my PSA will be rising and Really concerned that I’m off zytiga and prednisone, I’m on Skyrizi for colitis and plaque psoriasis.

Cancer thrives on inflammation now thatI’m off prednisone

Should I be on Xtandi and dexamethasone?

My Mo has me only on Firmagon right now with the cazibatoxel and carboplatin chemotherapy every 3 weeks for PCA adenocarcinoma liver metastasis.

After the 3rd round he will give me a FDG scan as I never had one.