My MO is changing my off of Abiraterone to Xtandi and wants to add Talzenna to my regime. Reading the FDA report on this 'new med' is scary and wondering if anyone in the community has used it and what side effects it gave them.
Thank you for your response.
I was on Abi for 2+ years changed to Xtandi due to possible heart problems . Became a zombie due to. side effects within couple of weeks. Thoughts now was that this was possibly due for stopping prednisone to quickly.
What's the purpose of that drug and how does that relate to Xtandi usage?
description from ChatGPT
Talazoparib is a targeted cancer therapy belonging to a class of drugs called PARP (poly ADP-ribose polymerase) inhibitors. It is primarily used to treat certain types of cancers by interfering with the cancer cells’ ability to repair DNA damage, leading to cell death.
Key Information:
1. Indications:
• Breast cancer: It is approved for use in patients with HER2-negative breast cancer who have a germline BRCA1 or BRCA2 mutation.
• Prostate cancer: It may also be used in certain cases of metastatic castration-resistant prostate cancer (mCRPC) with BRCA mutations.
2. Mechanism of Action:
• PARP inhibitors like talazoparib block the PARP enzyme, which is involved in repairing single-strand breaks in DNA. This makes it difficult for cancer cells (especially those with BRCA mutations) to repair damaged DNA, ultimately leading to cell death.
3. Administration:
• Talazoparib is taken orally, usually once daily, with or without food. Dosage may be adjusted based on side effects or specific patient factors.
4. Common Side Effects:
• Fatigue
• Nausea
• Anemia (low red blood cell count)
• Thrombocytopenia (low platelet count)
• Neutropenia (low white blood cell count)
• Loss of appetite
• Hair thinning or loss
5. Precautions:
• Regular blood tests are necessary to monitor blood counts.
• It is contraindicated during pregnancy due to the risk of fetal harm.
• Patients should inform their healthcare provider about any other medications they are taking to avoid interactions.
6. Brand Name:
• Talazoparib is marketed under the brand name Talzenna.
If you need more specific information, such as dosing details or clinical trial data, let me know!
I don’t understand your doctor wanting to put you in a trial that would benefit you IF you have BRCA mutations without testing you.
Here are two really good genetic testing labs
Hi Texas,
My situation is probably different from yours. My MO placed me on Zytiga AND Xtandi at the same time. This was a few years go. I'm surprised that my health insurance covered both of them. He took me off the medications after eleven months. I don't know whether or not they would recommend or approve this protocol today.. He was a young MO to whom I suggested the regimen. He readily agreed and wrote the necessary letters to my insurance provider. I think I did fairly well. For these past few years I have taken nothing but Avodart, although my PSA has been increasing lately and I am scheduled for a scan. Good luck!
Hi, maybe I missed it...but why is he switching you from Abiretarone to Xtandi ? Side effects ??
After being on LUPRON for a couple years my MO added Zytiga (Abiratereone) along with Predisone which I have been on along with the LUPRON for over 7 years now.
Recently, over the past year, , my PSA has started creeping up, albeit it slowly, but trending up. Was undetectable until this year(2024) when reported .22, .33, .36 and now up to .89 over the last 11 months. My testosterone has started showing a slight reading where it had been undetectable. Thinking is that Abiraterone has lost it's efficacy so MO wants to change to Xtandi as it handles things a little differently. Don't really understand it but at least I will not have to take pills on an empty stomach as the Xtandi can be taken with or without food. Cost of the Xtandi is exorbitant, my Part D covers it but the copay is high but manageable. However, the Lord BLESSED me with an unsolicited call from an organization that gives assistance to help pay for it. GOD IS GOOD!
My RO wanted to put me on the abi/pred combo in addition to Eligard after my PSA shot up after IMRT. However, my MO put me on Xtandi instead due to a history of liver issues. The PSA dropped like a rock. She also added Talzeena due to the ATM mutation found in my genetic screening because PSMA PET showed a couple of METS. The Talzeena caused such fatigue issues that I got a second opinion from a MO at UCLA that specializes in targeted treatments. He noted that the association of the ATM mutation with PCa was murky and told me that I could stop if it was causing such strong side effects. I stopped and got SBRT for the MET on a rib. Currently, I'm on Eligard (3 month) and Xtandi. PSA is undetectable. Side effects seem to be diminishing.
Great news and pray for continued improvements and lessening side effects. When I read the FDA report on the Talzenna, I was shocked when it said 30% of recipients had to have a blood transfusion and of those 39%, 22% had to have a 2nd transfusion. A lot of other side effects , causing diminished levels of vital minerals, calcium, magnesium, potassium etc made me have 2nd thoughts on even trying it.
Thanks again for our response.
My MO did not prescribe it when I was on enzalutimide. I am mCRPC
The TALAPRO-2 results showed that TALZENNA plus XTANDI is the first and only PARP inhibitor in combination with an ARPI to significantly improve survival in patients with metastatic castration-resistant prostate cancer, regardless of mutation status,” said Roger Dansey, M.D., Chief Development Officer, Oncology, Pfizer. “Pfizer is dedicated to advancing scientific breakthroughs in genitourinary cancers, and these exciting TALAPRO-2 results further highlight our long-standing commitment to improving survival for men with prostate cancer.
Source : pfizer.com/news/press-relea...
FDA report on Talzenna is scary when 39% of recipients in their study had to have blood transfusions and of those 39% , 22% had to have a 2nd transfusion. That along with the warning of depleted levels of, calcium, magnesium, potassium and low platelet counts would make it difficult to consent to this treatment.
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