On March 4, 2014 I wrote a post “Castrate Resistant Prostate Cancer- What to Do Next” (www.advancedprostatecancer.net/?p=4425). The basic theme of the post was about how difficult it is to know how to sequence the new drugs we have to treat advanced prostate cancer (metastatic castrate resistant prostate cancer aka mCRPC). In the post I [...]
Confusion, confusion and more confusion, that is how I would describe the current decision making process for a man with prostate cancer that has become newly castrate resistant. Just a few years ago the decision tree was clear, castrate resistant, immediately on to chemotherapy with docetaxel. Today, in this treatment space, we have a number [...]
Since its FDA approval in 2011 FDA abiraterone (Zytiga) has supplanted docetaxel (chemotherapy), other than perhaps Provenge, as preferred first-line treatment for metastatic castrate-resistant prostate cancer. August 2012 saw the FDA approval of enzalutamide (Xtandi) for the treatment of castrate-resistant prostate cancer after chemotherapy. Researchers performed a retrospective chart review at a large medical oncology [...]
After a great deal of confusion and what turned out to be an error on my part I wish to let you know that the NICE (The U.K.’s National Institute for Health and Care Excellence) Guidance I shared on the blog on January 28, 2014 (http://advancedprostatecancer.net/?p=4360 ) about enzalutamide (Xtandi) was not accurate. In my [...]
An important update from the phase III PREVAIL study (Xtandi in the pre-chemotherapy stage) was released thsi evening (actually yesterday evening) in advance of a formal presentation this Thursday at ASCO GU. The news is good, no the news is great. Last November the trial of Xtandi in men with metastatic castrate resistant prostate cancer [...]
Live in the UK and have advanced prostate cancer? If you do then be prepared to have economics over-ride your legitimate health concerns. The U.K.'s National Institute for Health and Care Excellence (NICE) makes no bones about what is more important, money or men’s health. NICE initially did not approve Zytiga, however when Johnson & [...]
Based on the assumption that Enzalutamide (Xtandi) is approved for use in men with castrate resistant metastatic prostate cancer (advanced prostate cancer or mCRPC) who have not had prior chemotherapy, pretty much a foregone conclusion based on the extraordinary phase III Prevail Trial results, including a statistically significant survival advantage of 2.2 months with a [...]
When I was first diagnosed with metastatic prostate cancer one of the first questions that I asked my doctor was whether it made sense for me to start chemotherapy immediately. I very clearly remember him telling me that there was absolutely no evidence that starting chemotherapy at this early stage would do anything to extend [...]
Fail First Therapy or Step Therapy has been a topic I have written about in prior posts. It is my considered opinion that as it works its way into the treatment protocols for advanced prostate cancer it will have nothing but a very negative result for our health and longevity. What is Fail First Therapy [...]
I was lucky enough to have a consultant here in the UK who was able to get me Enzalutamide (Xyandi) on a compassionate use basis. It worked well for some six months for which I am very thankful but I suffered from an unusual, though listed, side effect. Apart from fatigue, which seems to be [...]
