Rechallenging PC with ADT following Chemotherapy?

[NDJIM]

I heard somewhere that drugs such as Aberaterone and Xtandi can sometimes start working again following chemotherapy. Is anyone familiar with this?

[Mascouche]

Here is what the perplexity AI has to say about this:

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Yes, there is some truth to the idea that drugs like abiraterone (Zytiga) and enzalutamide (Xtandi) can sometimes regain effectiveness following chemotherapy in prostate cancer treatment. This phenomenon is known as "resensitization" and has been observed in clinical practice and research. Here's a summary of the key points:

Resensitization to Hormonal Therapies

Resensitization refers to the renewed effectiveness of a drug that had previously stopped working. In the context of prostate cancer treatment:

Some patients who progress on abiraterone or enzalutamide may respond again to these drugs after receiving chemotherapy.

This effect has been observed in both directions - patients may respond to abiraterone after enzalutamide and chemotherapy, or to enzalutamide after abiraterone and chemotherapy.

Evidence from Clinical Studies

Several studies have provided evidence for this phenomenon:

A study found that patients who had received docetaxel chemotherapy before abiraterone gained similar benefit from subsequent enzalutamide treatment compared to those who had not received chemotherapy.

The RESTORE study showed that some patients who progressed on enzalutamide or abiraterone could respond again to the same drug after receiving bipolar androgen therapy (BAT).

Potential Mechanisms

The exact mechanisms behind this resensitization are not fully understood, but some theories include:

Chemotherapy may alter the tumor biology, making it responsive again to hormonal therapies.

The break from hormonal therapy during chemotherapy may allow some cancer cells to regain sensitivity to these drugs.

Clinical Implications

This phenomenon has important implications for treatment sequencing in advanced prostate cancer:

It suggests that patients who progress on one hormonal therapy may still benefit from another after chemotherapy.

It opens up more treatment options for patients with advanced disease.

Considerations

While this resensitization effect is promising, it's important to note:

Not all patients will experience this effect.

The duration of response after resensitization may be shorter than the initial response.

More research is needed to fully understand and predict which patients are most likely to benefit from this approach.

In conclusion, while not guaranteed, there is evidence to support the possibility of drugs like abiraterone and enzalutamide regaining effectiveness in some patients following chemotherapy. This highlights the complex and dynamic nature of prostate cancer treatment and the importance of individualized treatment approaches.

[Tall_Allen]

Xtandi, not abi:

prostatecancer.news/2022/10...

[Ian996]

I was taking Xtandi for 2 years and it did lower my PSA ...until it didnt I started Docetaxel 6 weeks ago so I cant comment on whether it is working for me