The U.S. Food and Drug Administration (FDA) has approved a generic version of Zytiga, the new drug’s name is Yonsa. It is a novel formulation of abiraterone acetate that needs to be used in combination with methylprednisolone for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC).
There are a number of items including Medicaid Expansion (or the lack of it), Family Leave and the latest attempt by certain states to screw people with pre-existing and serious chronic illness despite the federal laws protecting our medical insurance.
Statins have been in the prostate cancer news feeds for a long time. They are believed to potentiate the effects of the anti-hormonal agents used to treat metastatic castration-resistant prostate cancer (mCRPC). Different stages of prostate cancer as well as different treatment exposures might change the efficacy of statins.
Why doesn’t someone newly diagnosed with prostate cancer automatically receive chemotherapy along with hormone therapy (ADT)? There is a good reason.
Men with metastatic prostate cancer (mCRPC) who do not respond to hormone therapy (ADT) or who experience early progression (≤1year) have a poor prognosis. There is no consensus regarding the proper next therapy for these men.
The technology, PET/CT exemplifies one of the most sensitive of the diagnostic modalities we have to assess the spread of recurrent prostate cancer.
However, there is an assumption that even PET/CT, despite its sensitivity, still under-estimates the actual tumor burden. There is an additional hypothesis that the under estimation of tumor burden increases progressively by the number of positive nodes that are visualized by preoperative imaging.
In men with node positive recurrent prostate cancer researchers assessed the value of using metastasis-directed therapy (MDT; salvage node surgery or radiation) compared to the standard of care using hormone therapy (ADT).
Having positive lymph node metastasis (LNM or pN1) after a radical prostatectomy (RP) to treat prostate cancer is a poor prognostic indicator. Knowing what the next best course of treatment is if you are in this situation remains questionable. To begin to understand and better answer this problem a group of researchers performed a comparative analysis of three of the current management strategies for men with positive lymph nodes after RP.
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.