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Timing of ADT + Zytiga - Anyone else start them at different times?
I have locally advanced disease (+ pelvic nodes). My treatment is based on the intensification experiment in one of the arms of the STAMPEDE trial in which abiraterone (Zytiga) was added to radiation and regular ADT (i.e., Lupron) for 24 months in the experimental arm, with then Standard of Care of RT + ADT in the control arm. The benefits from the intensification with abiraterone in the trial were substantial in terms of BCR failure-free duration.
I started Orgovyx in July 22 but didn't start Zytiga until April 23. The reasons for the delayed start aren't relevant to my question. As I will have taken Orgovyx 24 months at the end of this June, the question that naturally arises is: (a) do I stop taking these two meds when each hits 24 months (this July for Orgovyx and May 2025 for Zytiga); (b) stop both this July; or (c ) take both until May 25?
I've gotten two different answers ( (a) and (c ) above) from two oncologists from two NCCN designated cancer centers. Ultimately it will be my decision to make, just wondering if anyone else is in this situation and if so, what guidance you've received. I'd like to stop both in July because I'm wearing down from the intensified treatment but don't want to compromise the results proven from the trial. Typical PCa dilemma!
Thanks!
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I started Eligard (Leuprolide 3-month injection) in October 2022 (my PSA was 19.0) and in January 2023 my PSA had dropped to 0.4 so we added Zytiga (Abiraterone daily pills) and my PSA has now been less than 0.1 since April 2023 through January 2024. I plan to have another Eligard injection in April (lasts through June) and July (lasts through October) and continue the Zytiga through October, for a total 24 months of ADT.
Did you have prostatectomy and or radiation?
Prostatectomy in June 2013 with biochemical recurrence in August 2023. To the original poster question, I will be doing 24 months of Leuprolide and 21 months of Abiraterone.
Does your team plan radiation treatments to follow adt? Or will they watch psa? My situation is similar surgery then recurrence then adt. My question is what next. My team is fixated on radiation.
Upon bcr we did a series of imaging to locate the cancer. In my case it was in 20+ lymph nodes, so radiation wasn't seen as an option, so we went the adt route.
Surgery; then BCR PSA @ .19
Salvage radiation to whole pelvic region together with 4 mos ADT
First post tx PSA undetectable Nov 2023
Hoping for same undetectable at next PSA in later Feb
Best wishes.
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1 ReactionIf I may ask what are they considering as undectable?
And if undectable what was your actual number?
My health team considers "less than 0.1" as the goal (undetectable) for my situation of where I had a prostatectomy and BCR (19.0). They said that chasing the significant digits isn't worth it, just focus on "less than 0.1".
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Hug
1 ReactionSo they are telling you a psa of .08 is the same number as .03.or do they just it is less then .1 ?.
The latter. My health team says that for patients in my situation that they use the standard test that doesn't go into the additional decimal points. So, when I get my results, it will say "19.0" or "0.4" or "< 0.1". I have been "< 0.1" for the past 6 tests over the last 10 months.
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