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availability of Zytiga

skippy123
Posts: 7
Joined: Dec 2011

I am new to this disscusion board however, for those of you that beleive that Zytiga is only available for those who failed chemo treatments you are misinformed..acording to most insurance plans three criteria must be met that is 1. FDA approved 2. nonexperimetal 3. prescibed by attending physician...you may have to go through your medical plan and not you pharmacy plan but the drug is surely available and would be covered..I am one who did not take any chemo treatments and have been on Zytiga for 4 months currently..

VascodaGama's picture
VascodaGama
Posts: 1590
Joined: Nov 2010

Skippy

Thanks for the information.

Can you share your experiences with Zytiga?
Any symptoms?
How about outcomes?

Many here would appreciate to read about your history with PCa.

The best.
VG

skippy123
Posts: 7
Joined: Dec 2011

VG
Thanks for your acknowledgement to my first posting...as far as my experiences with PCa the journey has taken me 3 years so far.. rather than discuss the first 2 1/2 years (maybe at some later date)I would rather talk about my take on Zytiga at present..back in June and July of this year I was experiencing some increased back pain which would not go away..I tried standard over the counter pain meds but they only took the edge off but the pains would continue day after day..I knew the cancer was now in my bones and progressing..bone scans showed a number of suspected sights..it is important to note that I am an avid golfer and play at least 3-4 times a week (no cart ..I'm a walker)..I was able to continue playing but it became increasingly more difficult with the pain problem..I saw my Onco. and asked if I could go on the new drug Zytiga..he said that I needed to have chemo treatments before I could take the new drug..he felt if it were up to him he would start me before chemo at the same time he knew I was totally against chemo treatments..thats when I called my insurance company to see if I could start the new drug..as it turned out they were ok with me starting this new drug which I acquired within a week at the end of July..I've been on the drug for the last 4 months and as of present I have to say that back pain is no longer an issue..my psa numbers were off the charts in July but have come down 65-70% since then..I pray that they continue to decline but I'm more interested in how I feel than where a number is..my docter agrees with that position..he believes its more about how I feel at this point than what the numbers are..certainly I would like the numbers to go way down but managing this condition is more important and I believe we are currently achieving this with the help of this new drug..I will try to keep you posted as I continue with Zytiga .. its too early to tell where it will take me.

skippy123

VascodaGama's picture
VascodaGama
Posts: 1590
Joined: Nov 2010

It is wonderful to read reports about successful outcomes and yours is just great.
Zytiga is a wonder drug which development I have followed since 2007. It may be the drug that I will add to my hormonal protocol in future.
I only can image your full status but it is encouraging to read that one simple drug is giving you back a due quality of life. Another wonder drug that shows to cure/kill cancer metastasized in bone and relieves pain is Alpharadin . This is a newer drug “on-the-block” which just completed phase 3 trials with great success in treating prostate cancer. You may keep the name for future reference or need, if any.

I wish you continuous enjoyment in your T-offs and that Zytiga "zipps" the cancer out for good.

Thanks
VG

skippy123
Posts: 7
Joined: Dec 2011

Hi VG

In reading your response to my last posting(thank you) you indicated your belief that Zytiga can kill cancer cells (in bone etc.)..do you believe that by altering or incapacitating the cancer cell it effectively and permanently eliminates the cell?? if so could it be or would it be possible in the end result to permanently eliminate the cancer(theoretically)?? I am still learning how this drug works..that is will it be or could it be more effective for those who did not take chemo treatments before taking this drug(myself)..results have not been posted ..I know there are trials currently for chemo-naive patients with Zytiga..I guess in the end I'm hoping to control this beast even if its not possible to eliminate him entirely..I have 3 daughters and I want to be around to see them get married have kids etc..also thanks for the info on Alpharadin I'll be watching..I have to say that you clearly are a man with great intellect and considerable knowledge on PCa..I appreciate you input ..thank you again

Skippy

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

I am glad that your experience with Zytiga thus far has been positive. The Zytiga abbreviated clinical trial that has all of the relevant data was for men who had already had chemotherapy. There is absolutely no data at all available for use of this drug on men with metastatic prostate cancer who are not post chemo. Perhaps this isn't important and as you point out there is a trial underway to assess the use of this drug on men who have not undergone chemotherapy but at this point, you're basically a human guinea pig running your own trial.

In the trial results I didn't read anything about Zytiga killing cancer cells. What it said was that men in the trial group that received Zytiga had an extended survival of four months on average over men in the placebo group. While this is great news for the men involved, it hardly seems to me that this is a "cure" for prostate cancer although it may indeed be a step forward in more effective drug technologies for prostate cancer that is androgen resistant. The average age of men in the study was 69.

To be fair, Zytiga comes with a long list of potential dangerous side effects, particularly for men with cardiovascular problems. Zytiga also MUST be taken with prednisone, which also carries a long list of potential adverse side effects. Men should study these side effects carefully before jumping on the Zytiga train, in my opinion. On the other hand, men who have metastatic prostate cancer after chemotherapy don't have too many choices left and the potential side effects may seem a lot less scary than death from prostate cancer.

Dr. Charles Myers (a urologist suffering from prostate cancer metastasis), whom many readers of this forum refer to frequently, is not a fan of Zytiga and feels that there are safer (and more fully tested) drugs available for this condition. You can see his short videos on the subject by perusing his online blog at: http://askdrmyers.wordpress.com/

As Vasco has suggested, posting your background with prostate cancer would be useful for men who may have a similar history as they try to decide on which course is best for them. I appreciate that you may not want to write about it and would prefer to dwell on the positive effects of Zytiga in your life but frankly, one without the other seems a bit disingenuous to me and seems more like a Zytiga commercial rather than a peer-to-peer exchange of information between men suffering from prostate cancer. Your call obviously.

K

skippy123
Posts: 7
Joined: Dec 2011

Good afternoon Kongo

OK I will briefly edify the group concerning my past and present prostate cancer journey..I was dx in Dec. 2008 with a psa 189 and a gleason 8..my options were hormone and or radiation..I did both..Tomotherapy at UCONN. med. center in CT...psa subsequently went down to about 3 for about 5 months approx..then psa began to increase first slowly then at about 2 1/2 years within a 2 month stretch increased dramatically..in july of this year my psa had gone beyond 1000 and that is when I began the Zytiga..back pain was beginning to become a real factor quality of life was on a distinct down turn..I can assure you and everybody in this group I am NOT! a Zytiga commercial and far from disingenuous as you felt possibly I was..getting back to the drug as I understand it the binding to the cancer cell by this drug disables the cell to produce testosterone to continue or survive..in a theoretical way the cell can not continue to survive ..is this not a form of cell death or are we speaking semantics of some sort..either way the cell can not live and produce more cancer cells and or progress. as you pointed out there are certain potential problems with this drug but I believe the benefits far outweigh the down side at least for me at this point..

respectfully
Skippy

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Skippy,

Thanks for the update on you history with prostate cancer. I certainly have a lot of empathy with your situation and you obviously are going forward with your eyes wide open. I do wish you every success in your journey to subdue this beast.

K

VascodaGama's picture
VascodaGama
Posts: 1590
Joined: Nov 2010

Skippy

I may not be the right person to answer your above post. I have no medical enrolment. My knowledge is based on my researches and experiences along my journey.
You have erroneously taken my comment on Abiraterone as a sure cure of PCa, even in bone. Disclaim is set well by Kongo and I want to inform you that not all guys have benefited from the drug.

What I know about abiraterone acetate (Zytiga) is that it has been/is on several trials and that midterm reports shown success in all application. Is it taken as a substitute of antiandrogens in the typical HT protocol or as a second-line HT comparing with ketoconazole, or in hormone resistant cases before chemotherapy or thereafter. Some other drugs which have been developed for specific treatments have also shown better results when taken together with abiraterone, etc., etc.
However, this is a drug that is not for every patient. It got its pitfalls and risks which requires attention to details in use.

Abiraterone acetate (Zytiga) pertains in the group of targeted medications which has been revolutionizing the way on “how to treat”. These are drugs being tailored at the DNA to each particular illness (meaning that they can better address the problem presented by the cancer), but they should be administered under the monitoring of proper clinics.
The drug is used in a series of trials which list you can see in this link;
http://clinicaltrials.gov/ct2/results?term=abiraterone+acetate

Zytiga inhibits the enzyme CYP17 (17α-hydroxylase/C17,20 lyase) that has a role in the synthesis of androgens (testosterone and estrogens). This inhibits a protein (cytochrome p450) involved in intratumoral testosterone production.
The principle is to stop feeding testosterone to cancerous cells, “killing” them by starvation. Surely this is valid in cases that respond to hormonal manipulations (not chemo manipulations).
In the process, one can expect that many cells dye but not all cancer depends on testosterone and some mutate to live with other means. Those become aggressive to treatments and propagate uncontrolled. At first signal of refractory, doctors usually increase the dosage or substitute the drugs by others of similar category.

Other drugs of the same group on trials with similar results are, namely; MDV-3100, TOK-001 and Orteronel. You can search for details at; www.clinicaltrials.gov

There are many sites explaining about Zytiga and its side effects. Because it was approved for use after failed chemo, some doctors are prescribing it “off-label”. I read the stories of guys on the drug who have not been on chemo like you.
In Wikipedia site (recently edited) they have an easy to understand explanation on the drug’s mechanism of action as follows;

“Abiraterone inhibits 17 α-hydroxylase/C17,20 lyase (CYP17A1), an enzyme which is expressed in testicular, adrenal, and prostatic tumor tissues. CYP17 catalyzes two sequential reactions: (a) the conversion of pregnenolone and progesterone to their 17-α-hydroxy derivatives by its 17 α-hydroxylase activity, and (b) the subsequent formation of dehydroepiandrosterone (DHEA) and androstenedione, respectively, by its C17,20 lyase activity.[6] DHEA and androstenedione are androgens and precursors of testosterone. Inhibition of CYP17 activity by abiraterone thus decreases circulating levels of testosterone”.

I am confident that abiraterone acetate (Zytiga) in a cocktail with other drugs addressing bone metastases (such as Xgeva) may care your case better. You should discuss such possibility with your doctor because Zytiga interacts with other medicines which may turn out to be prohibitive.

In any event, you can expect long periods on the effectiveness of the drug, before moving into a different drug (maybe Orteronel), and surely you will live many years to see your daughters married and their kids.

Wishing you continuous good outcomes.

VGama

skippy123
Posts: 7
Joined: Dec 2011

To VG

It seems that I may not be on a sufficient intellectual level to converse with you on the subject of Zytiga based on your recent reply..I'm certainly not going to argue with your analysis of the drug and how it works..I guess not knowing all the specifics puts me at a disadvantage..however I'm walking the line at present hoping my results may exceed those recorded from previous trials..at the very least this drug for the time being gives me some hope or allows me the time to survive until a better drug is introduced..to me its all about controlling the beast even if eliminating it is not possible..I still say as Jimmy V said not very long before he succumbed to a different form of cancer that one should never give up never give up.

skippy

tarhoosier
Posts: 187
Joined: Aug 2006

There have been several trials of Abiraterone used pre-chemo and the results have been good, considering the alternatives. Generally, up to 70% of patients respond with a time to progression of 8-12 months. This is longer than seen in Abi used in post chemo men. This is for numerous reasons. The early trials of Abi Ph I and II have shown promise pre-chemo, and also post keto/pre-chemo. A fine drug, with issues of its own. I know two men who are on it now pre-chemo and happy for the option. Insurance coverage varies. Most men suitable to use it are willing to accept the conditions and side effects. I know that I would.
Wikipedia has a summary of Abi pre and post chemo.

skippy123
Posts: 7
Joined: Dec 2011

Thanks for your positive response I appreciate your input..I guess I will have to see if chemo-naive use of Zytiga will afford me a better result..only time will tell.. we are all snowflakes when it comes to cancer.

skippy

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