ZYTIGA: Our Collective Experiences

Same. I don't think my changes have been dramatic, though they are there and it's really bothering my wife. She was saying I should consider changing to enzalutamide. Spoke to one ONC today and will speak to one Thursday. Switching is not happening.

My wife seems a bit more accepting when I started research and it sounds like Enzalutamide is worse with mood changes. In additional to anecdoatal evidence, see this:

http://www.urologytimes.com/modern-medicine-feature-articles/cognitive-mood-effects-characterized-pca-therapies

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DX T4M1 GS: 8. 12/16. Age 65. PSA 240. Bone mets in femur, ribs, scapula, spine. Start ADT 2/17: Montly PSA declines: 28, 17, 9.5 . . .12/17 = 1.07; 3/18 = 0.7 [NADIR] Docetaxel May-Aug 2017; PROSTVAC (NCT02649855, 9/17 – 1/18). Provenge 3/18. RALP 5/18. Start Abiraterone 8/16/18. Result after 1 month: PSA 0.19
Next stop: radiation to bone mets

Starting Zytiga tomorrow. Been told to monitor my blood pressure and will need to get lab work done every two weeks for first 90 days. Here is looking at lowering my PSA and keeping it there!

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Age 59 when DX
DX Nov 2016
PSA 350
Bone & Lung Mets
Lupron every 3 months
Jan Biopsy 12 samples all positive
Gleason 9 ( 5 + 4 )
Jan 4 PSA 10.3
Feb 4 PSA 0.60 Feb Testosterone 0.2
Jan Docetaxel with Predisone 6 times 3 weeks apart, Apr 21 done
March start Zometa
April 4 Turp
PSA June .018 Sept .016 Dec .058
March 2018 PSA .320 Casodex added
June PSA .81
August PSA 2.6

Prednisone..Lets talk about Prednisone for a minute..Once you have been taking this drug for a while, you can't just stop taking it cold turkey...You must taper off it slowly. Pred shuts down your adrenal gland and it takes a while to get it up and running again. If you stop taking prednisone suddenly, you can get into all sorts of trouble..

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Age now 75 . Diagnosed G-9 6/2010. RALP, Radiation failed
Lupron, Zytiga, PSA <0.1 10/16 no change <0.1 5/17 PSA 1.6 Chemo or Provenge next..Sept '17, PSA now 9.2. ADT including Zytiga has failed. Will investigate treatment options. 11/17 PET/CT clear, but 4 new bone mets..Going to try Xtandi and see how I respond to that..3/2018 PSA now 54, chemo next. 5?10/18, PSA 200, Dosetaxel started..

Go Bucks: I've been on Zytiga for a month now and I haven't noticed any mood changes. Wife hasn't either (unless she's making me feel better by denying). I'm still on monthly Lupron and quarterly xGeva for bone mets, dropped Casodex last month for Zytiga, and take 5 mg prednisone.

Take prednisone in the AM, Zytiga before bed (after 2 hours of eating). So far, so good. My PSA has been eerily stuck on 0.60 the past three tests over 2 1/2 months.

Fairwind: Have you started Docetaxel? If so, how's it going? My six treatments ended in late May. Feeling MUCH better now.

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Age 62, SoCal
Diag PC May ‘17 PSA 18; high 58
Diag PC IV after C-11 scan; Lymph/bone mets
Casodex started 9/28/17 when PSA = 58
Lupron started 11/28/17 when PSA = 23
PSA 1/30/18 = 2. 82
Taxotere #1 2/7/18 at Keck/USC Newport Beach, CA
PSA 3/8/18= 3.00; 4/3/18= 2.00; 5/4/18= 2.30
Taxotere #6 (final) 5/23
PSA 6/4/18= 1.10; 7/2/18= 0.70; 7/25/18= 0.60
Diet 98% Vegan - no alc

Everton, I like Miralax or at Costco Laxaclear.

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Dx 5/18/17
11 of 12 cores positive 2 4+4
RALP 7/27/17; 3 pos nodes
No RT b/c scan shows multiple bone mets
Cleve Clinic upgrades to G9
Local & Cle Clinic MO agree ADT + Zytiga +Pred
psa post op 8/31 0.15 to 0.28 11/9
start lupron 11/17
psa 12/8/17 0.13;
start zytiga 12/15
psa 12/28 0.03
4/4=<0.01
7/3=<0.01
stop Zytiga 7/16 due to bad liver #'s
9/11/18 restart Zytiga
9/17 1/2 dose
10/5=<0.01!

Get another opinion. In a similar position and have been told there are several oral treatments available before chemo.

You PSA is still going down on Zytiga, that is good.

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DX 55 Yrs Old - T4,N1,M0
11/13 - PSA 130, MRI BX -8/8 cores positive -G8 (4+4), BS Mets spine hips ribs, No Symptoms
11/13 - Firmagon, 12/13 Trial S1216,1st Lupron, Casodex

My PSA Chart

Zygita 4/17

Post Edited (kmclark1) : 10/13/2018 9:09:02 AM (GMT-6)

Chase. I am in Boston. Going to have a detailed discussion first of January. Will let you know

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DX 55 Yrs Old - T4,N1,M0
11/13 - PSA 130, MRI BX -8/8 cores positive -G8 (4+4), BS Mets spine hips ribs, No Symptoms
11/13 - Firmagon, 12/13 Trial S1216,1st Lupron, Casodex

My PSA Chart

Zygita 4/17

Break60 said...
I’ve read elsewhere that taking a lower dose of Zytiga with food is effective . Any comments?
Bob

Yes, there are several posts on HW making that observation. I believe it is important that the food be low fat.

You might well wonder why it is not prescribed that way, rather than to be taken on an empty stomach. I have heard a couple of theories. Firstly, I don’t think it can be guaranteed to be effective, so you might be risking an “underdose”. I have also heard it suggested that it could alter the side effects in an adverse way. And maybe more cynically it has been suggested that Jansen Biotech (the Pharma Co responsible for Zytiga) would drop revenue if everyone halved their dose, so they won’t propose that it be prescribed that way.

I have no idea of the veracity of any of these theories, but do plan to ask my Onco if he thinks my present dose of Zytiga might be more effective if I take it with a low fat meal.

Chas

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Dx 07/13 PSA 7.1 at age 68
08/13 LRP Gl 4+3 ter5 mgn+, SV, LN -, pT3a N0 Mx
11/13 PSA .07
12/13 12 month ADT
01/14 37 EBRT
11/14 Retentive. SPC installed
12/14 ADT Break. 05/14 - 09/15 PSA <.01
12/15 .01 O6/16 .09 09/16 .53!! 12/16 .71
03/17 2.6. ADT restart
07/17 .08
12/17 .09
02/18 .18
07/18 .42
Start Abiraterone
07/18 .86
08/18 .81
10/18 .76

Post Edited (Chask) : 10/15/2018 12:39:51 AM (GMT-6)

@ Chask & Break 60 My Oncologist has said if we do not see a drop in the next month, he will have me try it a dinner time, so there must be something about having it with a meal. He has not indicated if I would be taking it to half the amount that I am taking now.

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Age 59 when DX
DX Nov 2016
PSA 350
Bone & Lung Mets
Lupron @ 90 days
Gleason 9 ( 5 + 4 )
Jan Chemo
2017 June .018 Sept .016 Dec .058
2018 March .320 June .81 Aug 2.6
Zytiga Started Sept

Mel,
I really feel that you need not fear the Zytiga/prednisone combo. For me, there is very little side effects amd hopefully for you too. Also, I claim it will certainly kick the butt of that rising PSA..Undetectable..here you come! And claiming it ahead of time for you, Brother
Wings

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DX PCa-2012, age 57=GS 3+4=7 & 4+3=7 w/mets PSA=71.2
Lupron PSA=
1/13=2.7 2/13=0.7 3/13=0.2 6 /13=0.1
9/ 13=0.7 11/13=1.4 12/13=2.7 6/14=3.8 8/14=5.2 Zytiga:
9/14=1.4 11/14=<0.06 12/14=<0.06 1/15=<0.06 3/15=<0.06 6/15=<0.06
9/15=<0.06 12/15=<0.06 3/16=<0.06 6/16=<0.06 9/16=<0.06 12/16=<0.06
3/17=<0.06 8/17=<0.06 12/17=<0.06 4/18=<0.06 8/18=<0.06

Well, no Z for me at this time, but I'll be starting my 4th go-ahead with HT next week (Casodex and Lupron)

Mel

It's all a journey, right? Zytiga looks to be my last approved systemic therapy and I have been WAITING on it to tell me, one way or another, what to do about potential clinical trials-

They say you gotta give it a good 3 months to see if it eventually works or not; delayed response is not uncommon, maybe around 5% of guys IIRC.

I failed Xtandi real quick last year, so really expected Zytiga fail as well, but 3 months to know? ouch....

2 months in from Zytiga start- my PSA had gone from 8 to 24 in that period- at that point I was taking Tylenol 24/7 and oxycodone every 2-4 days for pain; lots of naps in the day, generally weaker and fatigued, looking down the barrel, sending out inquiries for clinical trials, thinking time is short.

But now, I seem to be taking less naps (lately not at all)- my energy improves greatly- I still take tylenol, but sometimes 2x a day rather than 3, oxycodone maybe every 4-5 days but pain is less widespread than before- my days are better.

I get labs every 2 weeks to monitor for liver effects, and this last time, my PSA went up to only 25 from 24- (PSAdt of 30 weeks vs 7 weeks after the previous lab)- is the Zytiga finally starting to do something? My body wants to say yes, but my brain sez "24 to 25? don't get too excited"- CT scan scheduled in a few days, labs in 9 days- we shall see. It may gum up access to a clinical trial, but I guess that is a good thing for a while.

So, in the context of a Zytiga experience, anyone else have a 3 month delay to effect? Anyone else have a "stable" PSA response and then stay on Zytiga as opposed to the big drops seen by most? Has anyone been treated with dexamethasone rather than prednisone with Zytiga, and how did that go?

still rockin' for now- battle on brothers
rf

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Dx 62yo
3/16 PSA 19.4
Status G10 M1a
5/9 ADT PSA 29.5
PROSTVAC ADT chemo (x4) NADIR .05 10/4
5/17 EBRT 37.5 Gy prostate hematuria
PSA 6/27 1.65 off trial -> Provenge
9/19 Xtandi: 0.85; 12/12 Xtandi fail
1/18: PSA 2.5 ->BAT; 7/6 off BAT PSA 6.0
6/26 TURP, tumor DNA no hits
8/11 PSA 8 start Abi
9/28 PSA 18