Experiences with

Enzalutamide

Making the Most of Hormone Therapy Some of the most exciting research focuses on how and when to best use two drugs, abiraterone acetate (Zytiga) and enzalutamide (Xtandi). They bring testosterone levels down to almost nothing, which starves prostate cancer cells of that hormonal fuel.

Enzalutamide (Xtandi). It's a pill that blocks cells from receiving androgens. It's approved for men with advanced prostate cancer who have tried other hormone therapies. Surgery to Remove the Testicles (Orchiectomy) Your testicles make most of your testosterone.

DaVinci RP in Nov 2012, Gleason 9 and PSA was 2.0 at 3 month check. Rad Onc advised salvage IMRT not likely to help as PSA was indicating systemic disease so we began continuous ADT which took PSA below .1 for the next 3 yrs. In Jan 2016 my PSA was again at 2.0 and we revisited the salvage RT option

RESULTS: We found weak evidence that enzalutamide outperforms AA with prednisone in terms of OS in the pre-docetaxel and post-docetaxel settings.

A week ago I posted a study: "Abiraterone or Enzalutamide in Advanced CRPC." "There is strong evidence that enzalutamide outperforms AA with prednisone in terms of radiographic PFS and PSA progression and PSA response rate but not OS in the pre and post-docetaxel settings."

A total of 34 patients with continuous measurements of FT levels and mCRPC status underwent therapy with docetaxel, abiraterone acetate, enzalutamide, cabozantinib, carboplatin or cabazitaxel.

This was true in spite of the fact that most of the ADT only men were later treated with chemo once they became castration resistant, and many had abiraterone or enzalutamide. In other words, early chemo combined with ADT worked better than late chemo after ADT had stopped working.

The toxicity seems to be low. " "... a survival benefit over approved standard therapies such as abiraterone, enzalutamide, radium-223-dichloride, docetaxel or cabazitaxel has not been shown.

Looks Like Myers was wrong about 2 better than 1 but I wonder if the combination would give a longer time to progression to mCRPC Gus http://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/93020-enzalutamide-in-combination-fails-to-improve-progression-free-survival-to-better-progression-free-survival-in-chemotherapy-naive-mcrpc-patients.html

Combination of simvastatin and enzalutamide exerted additive growth inhibition in both cell lines accompanied with strong induction of autophagy in LNCaP.

Gus http://www.hematologyandoncology.net/index.php/archives/may-2016/current-understanding-of-resistance-to-abiraterone-and-enzalutamide-in-advanced-prostate-cancer/

prostate cancer in men undergoing prostate needle biopsy." [7b] "In univariate analyses, NLR was a significant predictor of prostate cancer detection" [7c] "The GS 8-10 group had a significantly higher mean NLR compared to GS 5-6 (3.64 vs. 2.54 ...) and GS 7 (3.64 vs. 2.58 ...) patients." [8] Xtandi (Enzalutamide

Now that we're over that hump, I am getting excellent results from enzalutamide, dropping my rise in PSA from 17 back to 0.85, then down to 0.08.

We investigate the historical basis for this modality, detail recent early-phase clinical trials that have demonstrated the feasibility and efficacy of this treatment, and describe an ongoing clinical trial comparing this modality to a currently accepted standard of care, enzalutamide, for castration-resistant

Furthermore, the combination of indomethacin and enzalutamide resulted in significant inhibition of enzalutamide-resistant tumor growth.

[Epub ahead of print] Targeted suppression of AR-V7 using PIP5K1α inhibitor overcomes enzalutamide resistance in prostate cancer cells.

Abiraterone (had to come off for toxicity reasons), Enzalutamide and now cabazitaxel.

Meanwhile, additional Phase II trials are being planned using galeterone in the post-abiraterone and post-enzalutamide populations.

"A persistent NLR >3 during treatment with enzalutamide seems to have both A persistent NLR >3 during treatment with enzalutamide seems to have both prognostic and predictive value in CRPC patients. value in CRPC patients."

METHODS: We calculated the cost savings of performing AR-V7 testing in mCRPC patients prior to starting abiraterone/enzalutamide (and avoiding these drugs in AR-V7(+) men) versus treating all mCRPC patients empirically with abiraterone/enzalutamide (without use of the biomarker).