There was a large meta-analysis recently published that compared the efficacy of abiraterone acetate (Zytiga), enzalutamide (Xtandi), cabazitaxel (Jevtana) and Radium-223 (Xofigo) in the treatment of castration-resistant, docetaxel-resistant metastatic prostate cancer.
There is an ongoing conversation in an Advanced Prostate Cancer support group which we participate in where there has been a discussion about some individuals’ experience in dealing with liver metastases (Mets). The main take away from this conversation is that if you do develop liver metastases you should ask your doctor about adding Carboplatin to Taxotere Chemotherapy.
Since abiraterone acetate (Zytiga) was approved for men with metastatic prostate cancer, it is well known that taking the drug with food in your stomach as opposed to having an empty stomach enhances the amount of drug that becomes active. Given the very high cost of Zytiga, many men have been tempted to take fewer pills along with a meal.
There is a sad truth about the current state of affairs for the treatment of non-metastatic castration-resistant prostate cancer. Our treatments can best be described as being antiquated.
Once a man with metastatic prostate cancer becomes castrate resistant (mCRPC) it is common to add a bisphosphonate like injectable zoledronic acid (Zometa) or denosumab (Xgeva) to his drug regimen. Like all other drugs, bisphosphonates have unwanted side effects, some which can be mediated.
Older men (over 75 years) may consider having docetaxel chemotherapy despite their age. However, there should be a consideration of changing the dosing and the schedule.
Occasionally we hear that enzalutamide (Xtandi) increases the risk of having a seizure, especially in men who for some reason already have an increased risk. Are seizure rates in men with an increased risk factor affected by treatment with enzalutamide?
Primary, or first line Hormone Therapy (ADT) can involve some different drugs. However, the constant standard includes either a GnRH agonist, such as leuprolide or an antagonist like Firmagon and an antiandrogen like Casodex.
According to researchers, the drug Metformin, when given alone or in combination, will reverse resistance and to Xtandi in certain mice models.
The NCCN has listed apalutamide (Erleada) as a category 1 recommendation for the treatment of men with non-metastatic castration-resistant prostate cancer (M0 & CRPC).
The European Medicines Agency (EMA) has recommended halting the use of the Xofigo (radium-223 dichloride) in combination with Zytiga (abiraterone acetate) and prednisone due to a possible increased risk of death and fractures.
One of the questions that often come up is how long a man should use an antiandrogen drug like Casodex along with a GnRH agonist like Lupron or Zoladex? There is no question that an antiandrogen needs to be used before the first dosage of the agonist (Lupron), but should the antiandrogen be stopped or should it be continued along with the agonist (combining an antiandrogen along with the GnRH agonist is often referred to as a combined androgen blockade)?
First line Hormone Therapy (ADT) involves the use of different drugs. These drugs include three different classes of medications with three different modes of action. They include the GnRH agonists, such as leuprolide, antagonists like Firmagon and the antiandrogens like Casodex.
Preliminary data that suggests that men with cardiovascular disease being treated for metastatic prostate cancer may experience fewer cardiovascular events when treated with a GnRH antagonist, such as degarelix (Firmagon), compared with a GnRH agonist (Lupron, etc.).
Both Taxotere (docetaxel) and Zytiga (abiraterone) are approved for newly diagnosed men with very aggressive prostate cancer and who have not yet had any exposure to hormone therapy (ADT).
The two approvals lead us to the question, which of these treatment options would be best for you?
Axumin (fluciclovine F 18) injection has been added to the National Comprehensive Cancer Network® (“NCCN”) Clinical Practice Guidelines in Oncology for Prostate Cancer.
This coming Wednesday, February 21, at 5:00 p.m. Eastern time (2:00 p.m. Pacific), Cancer ABCs will be collaborating with Cure Talks, The topic of the conversation will be It the recently launched “Metastatic Prostate Cancer Project”.
he FDA approved a new advanced hormone therapy drug (a next-generation androgen receptor inhibitor) for the treatment of men with non-metastatic castration-resistant prostate cancer (NM-CRPC). This drug with the trade name Erleada (aka apalutamide), is the first drug approved in this disease space.
The Food and Drug Administration approved the use of abiraterone acetate (Zytiga) with prednisone for men with high-risk, castration-sensitive, chemotherapy-naive metastatic prostate cancer, but there are some hitches and hurdles.
Two different trials, SPARTAN and PROSPER, are reporting top-line results in the treatment of men with nmCRPC. The full results of these trials will be presented today at the Genitourinary Cancer Symposium in San Francisco where Cancer ABCs is in attendance.