Am I correct that when a patient becomes resistant to either enzalutamide or abiraterone, or has to stop due to arrhythmia one cannot be substitued for the other?
Other than docetaxel (chemo) are there other commonly used treatments after enzalutamide or abiraterone resistance?
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MooseJawg
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Yes, enzalutamide works a bit longer after abiraterone than the alternative sequence. But maybe enzalutamide works a bit longer as the first drug than abiraterone. I do not know if there are trials how long apalutamide works after enzalutamide or abiraterone.
Yes, it did. I drew the black lines into the graph and added the numbers to them. According to this presentation the average (=50%) is two months for Abi after Enza and four months for Enza after Abi.
That might be that ABI works so effectively initially. It has for me for the past 10 years, undetectable, at <008 . I do not believe Enzalutamide was available as a first line treatment 12 years ago, i might be wrong, not a doctor!!! i am also convinced my ONC Doc made the preferred choice 10 years ago between ABI and Docetaxel for me at least.
The data I presented refers to the question what to do when Abi or Enza fails. Should you take the alternative drug then? The data I had showed that Abi works for about two months after Enza and Enza works for about four months after Abi. Meanwhile I read another article which states six months for Apalutamide after Abi.
I did not want to make any recommendation whether to initially start with Abi or Enza.
I’m currently being treated at the Erasmus Medical Center, more precisely the Rotterdam Kanker Institute, by one of the 5 oncologists who specialize in prostate cancer. They do a lot of studies there, currently adding darolatumide to cabazitaxel to determine if this adds to higher survival rates.
Too bad there website and weekly newsletter is mainly in Dutch , the homepage is also in English stichtingduos.nl/foundation...
Enzalutamide on hold. Lupron every 4 months. Gliclacide and metmorphin for diabetes; candesarten and rosuvastatin high blood pressure, cholesterol; bisoprolol for irregular heart; zopiclone for sleep as needed; trying mirtazapine for appetite and sleep.
Oxycodon against the pain, prednisone with the chemo and monthly shot of Firmagon ( Degarelix ) . Only supplement is Calcium tablet , otherwise a healthy variety of foods : the disc of 5 as we call it in Dutch :
Lots of fruit and vegetables, whole wheat, less meat but more fish and plant based ,less fat only” good fats “ , no sugar and lots of water .
Yes in India Orchiectomy is popular. As of now dad is on Orgovyx which is one pill a day - if T levels remain low I think he prefers to stick with that for now. Have done a T test today. Will know later. Btw what are your T levels
It goes up and down because not only the testes produce testosterone but usually between 0.6 to 0.9 up to 1.85 what happened only ones. The minimum was 0.3 but I don't have that anymore. I am also on doxycycline and that kills gut bacteria which could start producing testosterone. It is only my speculation.
You are incorrect. There is no reason why you can’t take Abiraterone after Enzalutamide or vice versa when one fails. I did. The problem is the second one doesn’t work for long. When the ARPI drugs fail, an alternative to chemotherapy is Lutetium-177. Good luck!
When Xtandi failed after 66 months we took a shot at Zytiga plus prednisone. They figured about a 10% chance of success but had to give it a try. 1 year later PSA is still dropping so we are getting some good therapeutic results. Trying to postpone Chemo or Lu177 as long as possible and hoping more 2nd line ADT drugs hit the market soon.
You are definitely part of the 10%. Unfortunately, most of us, including me, switching ARPI drugs only works temporarily. Consider yourself fortunate. Your response is unique.
Ryder, I am very mindful of the providence given to me. There are few explanations other than Divine intervention. My MO told me I am a statistical anomaly. I'll take that. I often wonder what else am I doing that is helping? Anyway thankful to be living in the moment. May good thoughts flow your way!
In Vancouver Canada I am on Abi/Pred with Lupron just over one year all well so far…as next option .do you have a choice Chemo / Lu 177 ?… Seems like the 177 is a better cancer killer ?
Tell my oncologist😉 . I don’t think he’s wrong , the study published in the Lancet was pretty clear . And if it works only for a short time, is the worth it ? Quality of life vs quantity is definitely something my MO and I take in consideration when discussing next steps. Costs of prescription medication are covered by our national health insurance plan so no worries or obstacles there .
You can check out the NCCN (National Comprehensive Cancer Network) starting on page 49 for other options to treat hormone resistant metastatic prostate cancer after 2nd hormone therapy fails. nccn.org/patients/guideline...
It is about two years now and has not responded as well to meds as the Dr likes so now referred to another for possible ablation. However, for me the irregularity is not as onvious as before. Heart left ventricle pumping is at 42% whereas 50% + is normal. Thx for the question.
Docetaxel/Taxotere is often used between them when giving switching a try. Even if after a couple or so Docetaxel infusions if it is found the cancer is still progressing the activity of the Docetaxel in even those few injections can affect cross resistance increasing the chance that switching to the other 2nd gen hormone tx will have effect. Usually in play when going from Abi to Enzi.
Anecdotally it didnt work for me. Abi failed and had 3 Docetaxel infusions which didnt slow progression. Then started Enza. It worked the first month out of 3 and of course stopped the Enza then. Then a trial drug for awhile which I for the most part felt good while on until progression started again.
Finished my Pluvicto treatment last April and lucky to be on cloud nine during and ever since Pluvicto. Kinda like "riding the wave" as I said early in treatment when Abi lasted almost 14 months.
End of October was my 5 year anniversery so to speak. (G-9, 1621 PSA, lymph nodes pelvis to neck, bone mets skull to shins).
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