What To Do In Case Of Overdose
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
When you get Zytiga from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date they dispensed the medication.
The expiration date helps guarantee the effectiveness of the medication during this time. The of the Food and Drug Administration is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.
About The Latitude Study
The LATITUDE clinical study evaluated 1199 men with newly diagnosed, high-risk metastatic prostate cancer who had not previously received ADT. All patients had at least two of three risk factors: Gleason score of 8 or more, 3 or more bone metastases, or 3 or more visceral metastases . Individuals were treated with ADT plus Zytiga and prednisone, or ADT alone and directly compared.
After a median follow-up of 51.8 months and a final analysis the overall survival has been confirmed to be significantly longer for patients receiving Zytiga/ADT/prednisone. Zytiga treated patients survived on average 53 months compared to 36.5 months for ADT alone.
The combination of Zytig plus prednisone with can now be considered standard of care in patients with high-risk CSPC.
Metastatic prostate cancer has been treated the same way for over 50 years until Taxotere chemotherapy was shown to improve survival in 2015. Zytiga may be the next advance in treatment with the potential to further improve outcomes by combining it with Taxotere.
How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
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New Combination Of Old Drugs Improves Survival In Patients With Prostate Cancer
Adding Zytiga plus prednisolone to standard therapy lengthened survival.
A novel combination of well-known drugs prolongs survival in patients with hormone/castration-sensitive prostate cancer, according to late breaking research presented at the European Society for Medical Oncology annual meeting .
The PEACE-1 and STAMPEDE studies found that the addition of abiraterone acetate plus prednisolone to standard therapy lengthened survival compared to standard therapy alone.
For men with metastatic prostate cancer, androgen deprivation therapy was the standard of care for decades. In 2015, docetaxel was shown to improve survival when added to ADT and in 2017, abiraterone was also shown to improve survival when added to ADT. Until now, though, it was unknown whether one or both agents should be added to ADT to achieve the best outcomes. PEACE-1 found that using three drugs upfront is better than just two in men with metastatic prostate cancer, not only to postpone cancer progression, but also to prolong life. When AAP was added to ADT and docetaxel, men experienced an additional 25% reduction in the risk of death compared to ADT and docetaxel alone.
The trial found that at six years, men who had received standard treatment plus AAP for two years had an improvement in metastasis-free survival from 69% to 82%, an improvement in overall survival from 77% to 86% and an improvement in prostate cancer specific survival from 85% to 93%compared to standard treatment alone.
Castrate Refractory Prostate Cancer: A Wider Range Of Options
In this section, we explain the treatments available at Birmingham Prostate Clinic for patients once their disease becomes resistant to hormone treatment, called castrate refractory prostate cancer. Two types of treatments are needed to:
- Control the cancer and prevent further spread of cancer
- Control or prevent the symptoms caused by the spread of prostate cancer to the bones
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Adding Abiraterone Improves Survival
According to ESMO, around 2 in 10 prostate cancers that havent spread are considered high risk, meaning theyre more likely to grow or spread within a few years. Current treatment for men with this type of prostate cancer is a type of hormone therapy known as androgen deprivation therapy. Some men will also have radiotherapy.
As part of STAMPEDE, researchers tested if adding additional hormone therapies either abiraterone or abiraterone and enzalutamide could delay cancer spread and improve for these men.
Stage Iv Prostate Cancer Prognosis
Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.
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What Is The Life Expectancy Of Someone With Metastatic Prostate Cancer
In the past, the life expectancy of men with metastatic prostate cancer was 2-3 years. But with advancements in medicine and care, the life expectancy of men with metastatic prostate cancer has increased to about 5-6 years.
The 5-year survival rate of metastatic prostate cancer is 28%, which is much lower than local and regional prostate cancers. This refers to the percentage of people diagnosed with a particular cancer who can expect to live for at least 5 years after diagnosis.
Taking Zytiga With Food
Take Zytiga on an empty stomach, either one hour before a meal or two hours after a meal. Taking Zytiga on an empty stomach helps decrease your risk for side effects.
Take your dose of Zytiga with a glass of water.
However, according to current treatment guidelines, taking Zytiga with food may be an option. Talk with your doctor if you have questions.
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Managing Bone Pain And Weakness
Symptoms like nausea, hot flashes, and pain can usually be relieved with medication. Some people find that complimentary treatments like acupuncture or massage help manage side effects.
Your doctor may also recommend orthopedic surgery to stabilize your bones, relieve pain, and help prevent bone fractures.
Data Collection And Variable Defining
After the study population was determined, we connected data from the TCR file, the cause-of-death file, and the inpatient file for each patient. We obtained cancer-related characteristics, cause of death, comorbidity status, and personal history . The data collection period covered September 2016 to December 2017. We also obtained duration of follow-up and duration of medication use. We observed any newly developed comorbidities for every patient in the study population. First, we determined the presence or absence of comorbidities by screening ICD-9 and ICD-10 codes for items included in the CCI, such as myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, rheumatic disease, mild liver disease, diabetes without chronic complication, diabetes with chronic complication, hemiplegia or paraplegia, renal disease, any malignancy except malignant neoplasm of skin, moderate or severe liver disease, metastatic solid tumor, and HIV/AIDS, from inpatient and outpatient files of the NHIRD for every patient . The newly developed comorbidities were defined, in any individual patient, as those extracted before the end of 2018 minus those extracted before the respective start date of abiraterone or enzalutamide treatment .
FIGURE 1. Flowchart of subject enrollment and data collection.
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Zytiga Approved For Prostate Cancer In 2011
The US FDA originally approved Zytiga for the treatment of advanced prostate cancer in 2011 based on a study that enrolled 1,195 men from 13 countries. The study participants had metastatic, hormone-refractory prostate cancer that has progressed after chemotherapy. Patients were treated with either Zytiga plus prednisone or prednisone alone. Zytiga improved overall survival by four months .
Keeping Health Insurance And Copies Of Your Medical Records
Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and although no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.
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Zytiga Prolongs Time To Pain Progression
The addition of Zytiga® to prednisone also significantly delays patient-reported pain progression and health-related quality-of-life deterioration compared with prednisone alone in chemotherapy-naive men with metastatic castration-resistant prostate cancer, according to the results of a study published in The Lancet Oncology.
In an international, double-blind trial, 1,088 patients with progressive, metastatic castration-resistant prostate cancer were randomly assigned to receive Zytiga plus prednisone or prednisone plus placebo in continuous 4-week cycles. Researchers measured patients pain and health-related quality of life questionnaire). The researchers then analyzed the data to evaluate clinically meaningful pain progression and deterioration in HRQoL.
At a median follow-up of 22.2 months, the median time to progression of mean pain intensity was significantly longer in patients receiving Zytiga/prednisone than in those receiving prednisone/placebo . The median time to progression of pain interference with daily activities was also significantly longer in the Zytiga group10.3 months compared to 7.4 months. Whats more, the median time to progression of worst pain intensity was also longer in the Zytiga/prednisone group compared to the prednisone/placebo group , but the difference was considered non-significant.
The median time to HRQoL deterioration was longer in patients receiving Zytiga/prednisone than in those receiving prednisone/placebo .
References:
Prostate Cancer Drug Zytiga May Extend Life
Study Shows Zytiga Adds 4 Months of Life to Patients With Advanced Prostate Cancer
May 25, 2011 — The newly approved prostate cancer pill Zytiga may extend life by up to four months in men with spreading cancer who have already been treated with chemotherapy, a study shows.
This survival gain “means quite a bit,” says study researcher Howard I. Scher, MD, chief of the genitourinary oncology service at Memorial Sloan-Kettering Cancer Center in New York City. “These are a group of patients for whom there is no standard of care and it is particularly gratifying to see these results, to say the least.”
The new study is published in the New England Journal of Medicine.
Prostate cancer is the most common cancer diagnosed in men besides skin cancer, according to the American Cancer Society. One out of every six men will be diagnosed with prostate cancer during his lifetime.
The new drug, which was approved by the FDA in April, inhibits a protein that helps form male hormones. The findings may help reshape the way doctors view and treat advanced prostate cancer.
The new study included 1,195 men with metastatic prostate cancer whose disease had progressed after chemotherapy. Those men who received steroid therapy along with the new pill survived for 14.8 months, on average, compared with 10.9 months seen among those who received a placebo along with steroids. This translated into a 34% reduction in risk of dying, the study shows.
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Life Expectancy And Localized Prostate Cancer
So how do these treatments affect life expectancy? In one study, researchers in Switzerland examined the treatment and outcomes of 844 men diagnosed with localized prostate cancer. They compared men who had been treated with prostatectomy, radiotherapy and watchful waiting and found that at five years from diagnosis, the type of treatment made little difference to survival. When the researchers went to 10 years from diagnosis, they did find a difference in survival based on treatment, but it was fairly small.
After 10 years, 83 percent of the men who had gotten a prostatectomy were still living, compared to 75 percent who had undergone radiotherapy and 72 percent who took a watchful waiting approach.
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Types Of Cancers That Are More Likely To Go Undetected
Some cancers are more easily detected than others. For example, certain types of skin cancer can be diagnosed initially just by visual inspection though a biopsy is necessary to confirm the diagnosis.
But other cancers can form and grow undetected for 10 years or more, as one study found, making diagnosis and treatment that much more difficult.
This table provides an overview of common cancers that often display little or no symptoms early on, and how theyre typically detected and diagnosed:
| Type of cancer |
|---|
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Enzalutamide Improves Survival In Patients With Metastatic Prostate Cancer
Summary
In an international randomizedphase III clinical trial, the hormone therapy enzalutamide extended survival in men with metastatic prostate cancer that had progressed during treatment with androgen deprivation therapy. Participants in the trial had not received chemotherapy.
New England Journal of Medicine, June 1, 2014.
Background
Early in their development, prostate cancers need relatively high levels of male sex hormones to grow. The testes are the main source of androgens, and treatments that stop the testes from producing male sex hormonesknown as hormone therapy or androgen deprivation therapy are therefore a common treatment for androgen-sensitive prostate cancer. However, most prostate cancers eventually become castrate resistantthat is, they can grow even when androgen levels in the blood are very low. ADT does not block production of the small amount of androgen that is made by the adrenal glands and by prostate cancer cells themselves, and this low level is sufficient to fuel the growth of castrate-resistant prostate cancers.
Enzalutamide is among several hormone therapies that have been developed to prevent the androgen-fueled growth of castrate-resistant prostate cancers. This drug works by keeping androgens from binding to the androgen receptors on prostate cancer cells.
The Study
Men in the trial were randomly assigned to receive 160 mg of enzalutamide or a placebo taken orally once daily.
Results
Limitations
- Posted:June 27, 2014
Editorial: Metastatic Castration Resistant Prostate Cancer: Prognosis And Treatment
- 1Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, United States
- 2Department of Urology, University of Kansas Medical Center, Kansas City, KS, United States
- 3Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States
- 4Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, United States
Editorial on the Research TopicMetastatic Castration Resistant Prostate Cancer: Prognosis and Treatment
Figure 1 Diagnosis and treatment landscape of prostate cancer. Figure was created using BioRender.com.
Irrespective of the treatment modalities, most CRPC patients develop bone metastasis. The metanalysis by Tong et al. assessed the prognostic value of skeletal-related parameters in mCRPC overall survival. This study examined the association between alkaline phosphatase, bone-specific alkaline phosphatase, urinary N-telopeptide, bone scan index, and overall survival in patients with metastatic PCa. The analysis revealed that higher levels of ALP, BSAP, and uNTx, progression of BSI, as well as BPI-SF scores were associated with lower OS in randomized controlled trials published between 2010 and 2019. Considering the ambiguity of the PSA value in mCRPC, bone-related parameters, AR variants, and, more importantly, CTC can help stratify the risk of mCRPC patients before the start of treatment.
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Combining Existing Drugs Improves Prostate Cancer Survival
Adding abiraterone to standard hormone therapy improves survival for men with high-risk prostate cancer thats not spread elsewhere in the body.
Todays results are the first study of intensified hormone therapy in this group, Professor Nick James, chief investigator of the STAMPEDE trial
The latest findings from the STAMPEDE trial, funded by Cancer Research UK and MRC, were presented today at the European Society for Medical Oncology conference.
The STAMPEDE trial results were published in The Lancet, showing that adding abiraterone to standard treatment could halve risk of death for patients with high-risk prostate cancer.
The combo is now being considered as an option on the NHS in England for this group of patients based on these findings.
Treatment With Abiraterone Significantly Improves Survival In Advanced Prostate Cancer
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
In December, researchers reported findings from a study showing that the drug abiraterone halves the risk of prostate cancer death among a specific group of patients who previously would not have been treated with it. Currently, abiraterone is approved only for men with prostate cancer that is spreading in the body. But men enrolled in the study were treated at earlier stages, before their tumors had a chance to spread. Based on the findings, the investigators concluded that abiraterone should considered for treating aggressive prostate cancer that has not yet begun to spread to other sites, but likely will in the future.
Abiraterone was first approved in 2011, specifically for metastatic prostate cancer that no longer responds to chemotherapy or drugs that block testosterone . Treatments that block testosterone production in the testicles and other glands are called androgen deprivation therapies, or ADT. Some tumors get around ADT by making their own testosterone, however, and that’s where abiraterone comes into the picture: it prevents cancer cells from making the hormone. Doctors give abiraterone together with prednisolone, a steroid that lessens treatment side effects. More recently, abiraterone’s approval was extended to men who still respond to ADT or have not yet been treated with chemotherapy.
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