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Abiraterone after enzalutanide (and the converse)...

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User
Posted 21 Jun 2019 at 14:35

Hello,

I understand that enzalutmide and abiraterone tend to be an either / or proposition, despite there being some evidence that about 28% of men will respond to the second drug once the first has failed.

That said, I note that some members here do appear to have received both. I guess this could be down to different rules in England, Scotland, Ireland, Wales. It could also be down to flexibility on the part of the oncologists.

Has anybody received both and if so could you please elaborate re the circumstances? 

Thanks

Jonathan. 

User
Posted 21 Jun 2019 at 15:52
Hi ,my OH is receiving both together but this is because he is on the stampede trial .

Hope others post as I’m sure there are a couple of men that have received the other drug if one has failed.

Best wishes

Debby

User
Posted 21 Jun 2019 at 17:36

Jonathan,

I have been on Abiraterone for 9 months now, but my PSA is beginning to rise, so I will,be moving on to Enzalutamide next.

I believe that if my treatment was funded by the NHS that would be a problem? but as my treatment is privately funded by BUPA there are no issues.

Regards

Dave

"Incurable cancer does not mean it is untreatable and does not mean it is terminal either"
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User
Posted 21 Jun 2019 at 15:52
Hi ,my OH is receiving both together but this is because he is on the stampede trial .

Hope others post as I’m sure there are a couple of men that have received the other drug if one has failed.

Best wishes

Debby

User
Posted 21 Jun 2019 at 16:21

Thanks Debby.

Boy, I wish I could have got my Dad on that!

Cheers

Jonathan.

User
Posted 21 Jun 2019 at 16:22
We were told that enzalutimide would not be an option if arberatitone failed but have not been told why unless it is just the decision of that particular hospital. I understand they don't think it would advantageous.
User
Posted 21 Jun 2019 at 16:36

I understand it’s a NICE budget decision. I live in France. Both are on the table if you need them, in whatever order.  I believe in trying to save life even against the statistical odds

User
Posted 21 Jun 2019 at 16:36

Hi Gilly,

It's because it is broadly held that if you failed one then you'd also be resistant to the other. However, up to about a third of folk might get benefit from enzalutamide after abiraterone... 

https://clinicaltrials.gov/ct2/show/NCT02125357

'Prior studies have reported Prostate-Specific Antigen (PSA) response rates of under 10% in patients treated with abiraterone after enzalutamide and 13%-29% in patients treated with enzalutamide after abiraterone'

Cheers

Jonathan.

User
Posted 21 Jun 2019 at 16:38

Hi Barry,

I appears to be a combination of budget and scientific reasons as above. 

Glad to hear that both are on the table in France for you...

Cheers

Jonathan.

Originally Posted by: Online Community Member

I understand it’s a NICE budget decision. I live in France. Both are on the table if you need them, in whatever order.  I believe in trying to save life even against the statistical odds

User
Posted 21 Jun 2019 at 17:36

Jonathan,

I have been on Abiraterone for 9 months now, but my PSA is beginning to rise, so I will,be moving on to Enzalutamide next.

I believe that if my treatment was funded by the NHS that would be a problem? but as my treatment is privately funded by BUPA there are no issues.

Regards

Dave

"Incurable cancer does not mean it is untreatable and does not mean it is terminal either"
User
Posted 21 Jun 2019 at 17:41
Hi,

My husband has had both. He was on a trial which included Abi. Was working well and PSA coming down but after 4 months suddenly severe liver problems. He did get better from this without any treatment just had to come off all medications. He was then allowed Enzo as the other had been a trial and not under NHS. It was also suggested as Abi was working Enzo was likely to. Enzo has worked well now for 6 months but unfortunately PSA has risen although he is very well in himself and no pains. So we wait and see what is said at next appointment.

User
Posted 22 Jun 2019 at 11:42

Thank you David - that's useful to know. 

 

Originally Posted by: Online Community Member

Jonathan,

I have been on Abiraterone for 9 months now, but my PSA is beginning to rise, so I will,be moving on to Enzalutamide next.

I believe that if my treatment was funded by the NHS that would be a problem? but as my treatment is privately funded by BUPA there are no issues.

Regards

Dave

User
Posted 22 Jun 2019 at 11:43

Thank you hiitsme.

Cheers

Jonathan.

User
Posted 23 Jun 2019 at 18:03

Hi Johnathon
I started on Stampede J Trial 53 months ago on Abbie + enzalutamide and Prostap. My psa at start of the trial was 235.
I stopped taking the Abbi due to some problems after about 1-2 months but have continued with the enzalutamide and Prostap. This has been successful for me in controlling my psa at around .05 and my cancer is dormant.
I'm sure my diet and other things have helped but I for one am a fan of enzalutamide.
Touch my next results in 3 weeks continue to be ok.

Best of luck to everyone

Paul

Edited by member 23 Jun 2019 at 18:06  | Reason: Not specified

 
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