It is interesting that Dr. S. Meyers just produced a video on the issue of using the newly approved drug Zytiga (abiraterone acetate) prior to chemotherapy instead of post-chemotherapy. I find it interesting because like him, I have been receiving a number of questions about this same issue.
Like Dr. Meyers, I too have been concerned about this surprisingly common question. Two different people have told me that their doctors at Sloan Kettering Memorial Hospital in New York City have been recommending this protocol, starting Zytiga prior to chemotherapy. They have also told me that their insurance companies have agreed to pay for this despite the fact the FDA has not approved it! I am glad that the insurers have been flexible, but I am not convinced that in this situation this is wise.
There has been no studies, small or large, to demonstrate that Zytiga is effective in this situation. As a matter of fact, it has not been demonstrated that Zytiga is even safe at this stage! Dr. Meyer’s video discusses this issue better than I am capable of, so I suggest that you view the video yourself.
See his video at: http://tinyurl.com/4xzsmfu
Joel T Nowak, M.A., M.S.W.
Sounds like a good protocol. If it had been available I would have tried it as I got the chemo upfront. I know at Dana Farber they had some protocols for trying that on high risk protocols prior to surgery. I don’t know the outcome of that. I know years ago when that was tried with Lupron and surgery it did not work in the long run.
Keep up the good work,
I have been on a PhaseIII trial of Abiraterone Acitate, in Australia, for the last 21 months. One of the exclusions for admittance to this trial is that chemotheropy has not been used prior to commencing this trial, information is at http://clinicaltrialsfeeds.org/clinical-trials/show/NCT00887198
I think is is totally misleading, to state that Abiraterone has not been been trialled in patients that have not undergone Chemotherapy prior to admittance to the trial.
As the above link shows, this trial is taking place in 150 countries, with around 1000 participants, it can hardly be called a “small trial”.
In the video DR. Meyers States that Abiraterone is a dangerous drug, I totally disagree, I have had little if any side effects from the drug, Prednisone is another matter, but is required to be taken with Abiraterone, it protects the patient from the mineralocorticoid imbalance that occurs when you achieve total CYP17 inhibition.
The trial that I am on is double blinded, but I know that I am taking the real drug, due to my PSA falling to 1.1 from 5.8 at the commencement of the trial, Prednisone alone could not be responsible for this decrease.
Hi Joel, I appreciate your website very much. I think so little is known about Zytiga that caution is indicated. I take zytiga and it is working at present. This was after taxotere failed, and Keto worked at high doses, before the zytiga was available. I am nervous about taking any thing with zytiga that will mess up its effectiveness, i.e. I asked Dr Meyers the other day if 50mg of saw palmetto in a multivitamin will adversely effect the zytiga, no ans yet.
Thanks so much Joel for your work for us hard case PC patients,who were hanging on by our finger-tips before Zytiga,
John, I am a little confused by your comment that it is misleading to say that Abi has not been trialed in patients that have not undergone chemo. If I read tour statement correctly an individual who has not yet had chemo is excluded from the trial, or the trial is only for men who have failed chemo (as I stated). If I mis-read your statement I would still make the same conclusion as the trial is still on-going sand we do not have results yet. – Joel
Thanks Jim- Joel
Dana Farber is conducting a trial using Abi, prednisone and dutasteride which I will be starting soon. No prior Taxotere.