Ask For a Blood test to identify AR-V7 in Circulating Tumor Cells if you are starting Xtandi or Zytiga

One of the hot topics in the prostate cancer community is the value of detecting AR-V7 tumor cells circulating in the blood. AR-V7 tumor cells in the blood predicts response or failure of treatment with enzalutamide (Xtandi) or abiraterone (Zytiga). A recent study found that men who have AR-V7 circulating tumor cells in their blood will not respond to Xtandi or Zytiga and will live longer if treated with a taxane based chemotherapy (docetaxel) regimen. A study in JAMA Oncology, showed that evaluating for the presence of circulating tumor cells (CTCs) with AR-V7 could optimize treatment protocols. The study looked at 161 men with progressing metastatic castration-resistant [...]

On The Horizon – Tests That Can Inform Us If A Drug Will Work Before We Take The Drug

We have become very fortunate over the last 6 years because our arsenal of potential drugs to treat advanced, metastatic prostate cancer has grown. All of our new drugs extend life and most offer palliation of pain. As I have discussed in prior posts we are still in a quandary about how best to sequence these new drugs. In addition, not all of us are going to be sensitive to all the drugs. The costs for these new drugs range from $4,500 per month to $145,000 for a complete treatment protocol. They are not cheap; they will involve a significant [...]

Our New Therapies and the Development of Cross Resistance to these Drugs

Men with metastatic castrate resistant prostate cancer (mCRPC) have become fortunate over the last few years as there we now have a number of new drugs available which can extend our life and can also have some palliative effects. However, as we have more treatments being approved, we find that we are faced with a significant issue, how to sequence these drugs. The major problem causing this sequencing crisis is cross-resistance. The use of each of any of these drugs limits the use of the another drug in men who have failed the original prior therapy. This problem, cross-resistance, is [...]

Is Cabazitaxel Before Docetaxel The Future Way To Go? *

Chemotherapy for prostate cancer is still limited to just two drugs, docetaxel (Taxotere) and cabazitaxel (Jevtana). Both of these chemotherapy drugs are taxanes, but they seem to be very different in their mode of action. A study published online in Clinical Cancer Research, indicates that cabazitaxel might be more effective for some men than docetaxel. Currently, the FDA label requires that a man fail docetaxel prior to being put on cabazitaxel, but it might be more effective for some men to first have cabazitaxel. Researchers have also found a genomic marker that could help clinicians identify which men might benefit [...]