Zytiga being prescribed following EBRT with PSA at 0.08

Posted by acn25 @acn25, 13 hours ago

My fact set:
Family history of prostate cancer. In 2024 my PSA drifted up to 10.92. January '25 biopsy: cores with Gleason scores of 4+3=7; 4+3=7; 4+4=8. PET/CT showed "no evidence of metastatic lesion." I decided to undergo external beam radiation therapy + ADT. Prior to beginning therapy on 5/1/25, I received Lupron shots and took Bicalutamide for thirty days, lowering the PSA to 3.35. Post therapy PSA of 0.08 on 7/8. Now, medical oncologist is prescribing abiraterone w/prednisone per "the new standard of care" for aggressive cancer. This seems excessive to me. Has anyone else encountered a similar situation?

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Brettiquette | @brettiquette | 12 hours ago

I’m in a similar situation as well. Surgery, radiation, lupron and I’m < .1. MO now recommending zytiga, I’m reluctant.
Encourage your opinions.

jeff Marchi | @jeffmarc | 12 hours ago

You want to add Zytiga. ADT plus ARSI is becoming the standard in order to get the longest progression free survival.

Combinations of ADT with ARPI and/or DOC have been a consensus guideline recommendation from ASCO and the American Urological Association since 2018 (2020 and 2023 for triplet combinations).6,19 These guidelines are based on phase III clinical trial findings demonstrating improved clinical outcomes, including progression-free survival and overall survival, with ADT combination therapy compared with ADT alone.

To read the whole article you can go here
https://ascopubs.org/doi/full/10.1200/OP-24-00690?bid=525230333&md5=efb3c3159aa147415d4f2ded3334efa3&cid=DM22814&mc_cid=3b04c1341f&mc_eid=99575fc699