Caution – The FDA Has Limited The Usage of Nizoral (ketoconazole)

Nizoral (ketoconazole, keto) is an older drug that has been used as a part of hormone therapy (ADT) for many years.  Keto, which is an inexpensive anti-fungal drug had been used for many years as an inhibitor of adrenal androgen synthesis as is abiriterone (Zytiga). Ztiga has been shown to be more effective, however, it is occasionally considered for treatment of metastatic prostate cancer in situations where a man can not afford Zytiga or it is unavailable.  The use of Keto in this manner is totally "off label." If you decided to try this route you need to also be [...]

The Well Reviewed Guide to Advanced Prostate Cancer (A Survivor Perspective) Has Been Updated and is Now Available for a free Download

Somehow I have been negligent and not let people know that I have written and posted a major update of my “Guide to Advanced Prostate Cancer.” As in the past, it is available as a free download from the Malecare web site. Helping me to update the book was prostate cancer survivor Craig Pynn and my own caretaker, Wendy Lebowitz. Anyone reading the first edition will be surprised when you see how many changes and updates this edition has included. It now has a very extensive conversation about living in the world as a cancer survivor as well as more [...]

A Surprising Biochemical Response to Ketoconazole In Post-Chemotherapy mCRPC Men When Compared to the Zytiga Trial Results

It has always been assumed that Ketoconazole, when used for the treatment of men with metastatic castration resistant prostate cancer (mCRPC), would not be as potent as abiraterone (Zytiga), but there has never been any head to head comparison to demonstrate this assumption! Ketoconazole is a less potent inhibitor of the CYP-17 enzyme, the mode of action of both these drugs, but it as never been shown that this translates into improved survival. Researchers analyzed the biochemical response rates in 30 post-chemotherapy mCRPC men who were treated with ketoconazole 200 mg TID plus prednisone 5 mg BID at a single [...]

Can Zytiga Be Used In Men Previously Treated With Ketoconazole: A Prospective Phase II Study

Some men with advanced prostate cancer have been given the antifungal treatment Ketoconazole (Keto) as a second line hormone treatment. Like Keto, this newer hormone treatment that is now available, Abiraterone acetate (AA) (Zytiga) works by inhibiting CYP17, the rate-limiting enzyme in androgen biosynthesis. The question being asked, if Keto has failed ,given its similar mode of action, can Zytiga still be an active agent? In the clinical trials for Zytiga men with prior keto treatment were excluded, so the utility of Zytiga after Keto is not well understood. In a prospective study the researchers evaluated the efficacy of Zytiga [...]