Lupron plus Xtandi Vs lupron plus xtandi plus chemo - survival ?

[Tinkudi]

Are there any studies which show survival or treatment efficacy rates comparing triplet therapy Vs just lupron and xtandi/zytiga

[Tall_Allen]

No such randomized trials. But ADT+docetaxel+abi (PEACE1 trial) gives about a year longer survival vs ADT+abi (LATITUDE trial)

[Tinkudi in reply to Tall_Allen]

Thanks Allen. It’s annoying that here in India no doctors seem to think chemo should be given concurrently - except the Tata doctor did mention that if dads health status is good then it can be thought of.

[jeetu_g27 in reply to Tinkudi]

Yes same here , even in case of my father AIIMS doctors said that they will consider chemo only when ADT fails . Triplet therapy is not in there Standard line of treatment . very confusing as I think AIIMS doctors are best in India .

[Tinkudi in reply to jeetu_g27]

Hi Jeetu. How old is your dear father ? What treatments is he on? I am in Mumbai. Will start the hormone treatment this week. Wondering whether to go with Firmagon or lupron

[jeetu_g27 in reply to Tinkudi]

Hi Tinkudi , I am from Haryana , getting treatment from AIIMS Jhajjar (National cancer Institute). My father is 69 years old . Currently he is on Lupron + Xtandi . Initial response is satisfactory PSA dropped from 79.5 to 7.95 . Next Screening is scheduled on this 26th june again . As much as i know through internet and discussions, Lupron causes an initial flare in PSA , to counter that the doctors has given bicalutamide 50 mg 10 days before starting Lupron and continued one week after Lupron . For firmagon PSA flare won't be there .

Best wishes and regards to your father 🙏

[Tinkudi in reply to jeetu_g27]

my best wishes and prayers for your father too 🤗🙏🏻

Did he have any side effects with lupron and xtandi ? Had you asked the doctors about Firmagon too - I think All doctors in India just recommend lupron

[jeetu_g27 in reply to Tinkudi]

yes there are some side effects like tiredness, hot flashes . The key here is to be positive , try if someone from family always be around him .

I didn't ask about firmagon , will try to ask in next visit .

As you know AIIMS is government owned and doctors here are somewhat arrogant , i have asked for triplet therapy option but they shrugged it off completely, saying its not as per their SOC .

[Tinkudi in reply to jeetu_g27]

I can understand. Indian doctors don’t like being asked many questions. It’s sad but true. Most have a condescending attitude.

[Tinkudi in reply to Tall_Allen]

Can it be any of the second generation ones like abi , xtandi ,nubeqa etc ?

[God_Loves_Me in reply to Tinkudi]

In other group, there is one user mentioned in India they had 2 dosage of Pluvicto + Xtandi and now next dosage of pluvicto next year, I do not know how efficiency .

The group name is " Pluvicto Patient Support Group " on Facebook. I think you may find many users from India as well.

Also talk your doctor about Pluvicto + Xtandi. Here is the clinical data from Allen

prostatecancer.news/2024/04...

[Tinkudi in reply to God_Loves_Me]

is pluvicto given instead of chemo ?

[God_Loves_Me in reply to Tinkudi]

Yes 👍

[Tall_Allen in reply to Tinkudi]

You already know what I think of his doctors who think nothing of spreading his cancer with biopsy needles. I know there are competent oncologists there.

[Tinkudi in reply to Tall_Allen]

Would you know any good ones names in Mumbai ?

[Tall_Allen in reply to Tinkudi]

Isn't Tata in Mumbai. I only know a radiation oncologist there - Vedang Murthy. Maybe call his office and ask for a recommendation.

[Tinkudi in reply to Tall_Allen]

Thanks.

[Tinkudi in reply to Tall_Allen]

Allen , just a thought. Why is it not SOC to do a PSMA for suspected patients rather than a biopsy , since there is risk of spreading ?

[Tall_Allen in reply to Tinkudi]

There are some experimental liquid biopsies that don't require needles. PSMA is a protein on metastatic tumors and may not appear in earlier localized PCa.

[Survivor1965 in reply to Tall_Allen]

TA, forgive me for my lack of understanding, but are you saying they did damage when I got my biopsy years ago?

[Tall_Allen in reply to Survivor1965]

No, I was responding to Tinkudi whose father is having an unnecessary biopsy. They already know he has distant metastases.

[Tall_Allen in reply to Tinkudi]

Triplet has so far only been proven for abi and nubeqa.

[God_Loves_Me in reply to Tall_Allen]

Agree

[docbulldog in reply to Tall_Allen]

Could Carboplatin be subbed for docetaxel with similar results?

[Tall_Allen in reply to docbulldog]

No. Platins have no benefit as a monotherapy for prostate adenocarcinoma and are more toxic.

[RodofGod]

i was advised that triplet therapy had a longer statistical survival rate.

in my case,

1. Lupron alone 2 years.

2. Lupron and Zytiga, 3 years.

3. Lupron, Taxotere, Lupron/Zytiga 5+ yrs.

I elected option 3. (Triplet therapy)

I was advised to hit it hard up front.

I liken Chemotherapy to ROUNDUP. It goes around killing those little bastards regardless of where they are hiding....

The trick is to be stronger than the treatment.

so far so good... < 0.1

Post RP with a chemical resurgence.

Diagnosis..

PC, ductal variant, stage IV, Gleason 8

.

[Tinkudi in reply to RodofGod]

Good luck 😊 since how long are you on the treatment. My dad is 83 so I am wary of the chemo part

[RodofGod]

Lupron started Oct 2023. (Ongoing)

Taxotere started Oct 2023.

Taxotere completed Feb 2024.

Xytiga and prednisone started Mar 2024.