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  1. Jim Marshall (not a doctor) said ... If you have castrate-resistant prostate cancer, common treatments that your doctor may add to your regular ADT treatment include: Docetaxel (Taxotere) Enzalutamide (Xtandi) or Abiraterone (Zytiga) Cabazitaxel (Jevtana). But what are your doctor's drug choices when the cancer is no longer under control after all three options? If you responded to docetaxel, your doctor knows you may well respond again to another dosing of docetaxel. But this increases your risk of side effects - especially peripheral neuropathy or nail di
  2. Jim Marshall (not a doctor) said … One of the most important meetings of doctors for men with advanced prostate cancer is the ASCO (American Society of Clinical Oncology) meeting held each year. Yesterday at the ASCO meeting Dr Maha Hussain, on behalf of her team presented the initial results of the PROSPER clinical trial. That trial tested whether men with no metastases, but who had rapidly rising PSA, would do better with early Enzalutamide (Xtandi). This presentation is just the start of scientific reporting. Dr Hussain is presenting this study to hundreds of
  3. Last Friday 10 March 2017 the Pharmaceutical Benefits Advisory Committee (PBAC) reached its initial decisions on drugs to go onto the PBS at reduced prices. This included whether to put Xtandi (Enzalutamide) before chemo on the PBS. The company will be told of the result next Friday 17 March 2017. If necessary, negotiations between the PBAC and the company continue for 4 weeks. The final results will be published on the PBAC website 21 April 2017. (If the company is not happy with the result, they have until July 2017 to appeal.)
  4. Thank you if you have sent in a submission. Thank you if you have considered sending in a submission, but felt you could not offer much. If you were leaving a submission until the last minute - that is NOW! Help get Xtandi (Enzalutamide) on the PBS for use BEFORE chemotherapy Click on this sentence to go straight to the PBAC to fill out the form. Click this sentence if you wish to see a short YouTube video about this. Click on this sentence to read about the drug and the online form. Closing date for comments is tomorrow Wednesday 8 February 2017 Late submi
  5. Details at the top of the page on: JimJimJimJim.com Click this sentence to go there. A gunner is a person who talks a lot about what he's going but doesn't' get around to doing it. "Gunna" (slang) = "going to" This is the last week before the public consultation closes next Wednesday 8 February. The Government is considering listing Enzalutamide (brand name Xtandi) on the Pharmaceutical Benefits Scheme (PBS) before chemotherapy. It's important that Australian men with prostate cancer, their partners,their families and
  6. Some members needed more technological help to find the form and the video. Here 'tis. Cheers. Jim Help get Xtandi (Enzalutamide) on the PBS for use BEFORE chemotherapy Click on this sentence to go straight to the PBAC to fill out the form. Click this sentence if you wish to see a short YouTube video about this. Click on this sentence to read about the drug and the online form. Closing date for comments is Wednesday 8 February 2017
  7. The opportunity There is a chance to have your voice heard on whether the drug Xtandi (enzalutamide) should be available on the PBS BEFORE chemotherapy. Timing Submissions are due Wednesday 8 February 2017, and no late submissions will be accepted. Enzalutamide on the PBS An important drug for men with advanced prostate cancer is Xtandi, also called enzalutamide. The first evidence that enzalutamide worked looked at using enzalutamide AFTER the chemotherapy drug docetaxel. A committee of experts looked at this evidence. They r
  8. Click here to read Malecare's report of a clinical trial which found that combining Xtandi and Zytiga and using them at the same time was NOT better then either of the drugs by themselves.
  9. Apalutamide (JNJ-56021927 formerly known as ARN 509) is a novel small-molecule androgen receptor antagonist similar to enzalutamide but with less central nervous system penetration, which could potentially result in reduced levels of fatigue and seizures. Curetoday.com has an article about 2 Phase 3 clinical trials of Apalutamide: the ATLAS trial (NCT02531516; learn more here); the SPARTAN study (NCT01946204; learn more here). The SPARTAN study is currently recruiting in Australia; the ATLAS study is not. For SPARTAN, eligible patients must show no signs of evident me
  10. The New Prostate Cancer Infolink has an article about the announcement of a new clinical trial of Enzalutamide (brand name Xtandi) in men with metastatic, hormone-sensitive prostate cancer. This trial will be recruiting men In Australia. The New Prostate Cancer Infolink expresses concern about the suitability of this trial for men newly diagnosed with a significant presence of metastatic disease. Click on this link to read the article.
  11. Respected prostate cancer advocate, Joel Novak from Malecare, believes that Xtandi is superior to Zytiga. Click on this link to read his reasons why he thinks this. Do you agree?
  12. Cabazitaxel is a chemotherapy treatment which is used when patients become resistant to chemotherapy treatment with Docetaxel. Cabazitaxel improves overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with Docetaxel. Androgen receptor splice variant 7 (AR-V7) in circulating tumuor cells (CTCs) from mCRPC patients was recently demonstrated to be associated with resistance to Abiraterone and Enzalutamide. A group of Dutch and Belgian researchers investigated whether this was also true for Cabazitaxel. They found that Cabazitax
  13. In the United States men with prostate cancer can get access to Abiraterone (brand name Zytiga) and Enzalutamide (brand name Xtandi) before chemotherapy. We'd like to get to a stage in Australia where Abiraterone (brand name Zytiga) and Enzalutamide (brand name Xtandi) are available on the Pharmaceutical Benefits Scheme before chemotherapy. The Australian Pharmaceutical Benefits Advisory Committee, when considering applications to put drugs on the Pharmaceutical Benefits Scheme, looks at what its overseas equivalent bodies have done. Thanks to member Russ for letting us know that
  14. At its November meeting the Pharmaceutical Advisory Committee (PBAC) considered an application to extend the listing of enzalutamide (brand name Xtandi) to include treatment of metastatic castration-resistant prostate cancer (mCRPC) in patients who have not had prior docetaxel (chemotherapy). The PBAC has released its decision on the application. It is what the PBAC describes as a "1st time decision not to recommend". It's disappointing that the application was not successful but encouraging that the PBAC is asking Astellas to resubmit the application. Here is the full de
  15. At its November meeting the Pharmaceutical Benefits Advisory Committee was considering whether Enzalutamide ( Brand name Xtandi) should be made available on the Pharmaceutical Benefits Scheme (refer to this previous post on the subject) One of the members in last week's teleconference asked when would we know the outcome of that meeting? Today the Pharmaceutical Benefits Advisory Committee published the outcomes from its July meeting. At this rate we won't know the outcomes of their November meeting until April next year. [Edit 18 December 2015 PBAC published its recommendation
  16. With increasing options to treat advanced prostate cancer, there is no clear agreement on the order in which these treatments should be given. I attach a chart prepared (following the STAMPEDE clinical trial which recommended early ADT and chemotherapy for certain patients) by an American oncologist setting out his view of what is currently best clinical practice in America. In Australia our options are more restricted: Abiraterone and Enzalutamide are only available on the Pharmaceutical Benefits Scheme after chemotherapy and Provenge is not available on the Pharmaceutical Benefi
  17. According to this WebMD paper, for patients prescribed the anticoagulant (blood thinner) warfarin there is a long list of medications that both patient and treating doctor must be aware as causing severe to serious to moderate side effects: http://tinyurl.com/qcafmkw Interesting, among them, are several that prostate cancer patients are prescribed including NSAIDs (identified here http://tinyurl.com/nhtjyvh), enzalutamide, corticosteroids (thus prednisone if prescribed abiraterone), acetaminophen, and several others. If you're a patient prescribed warfarin and also pres
  18. The American Prostate Cancer Foundation identified 8 highlights from this year's Annual Meeting of the American Society of Clinical Oncologists (ASCO).
  19. PLATO is a 2 stage Clinical Trial with 500 patients (80% in Australia, rest in Finland, UK and USA). On Stage1 everyone gets Enzalutamide (no placebo). [Xtandi is the brand name for Enzalutamide] Those continuing in Stage 2 are randomised: 50% of patients to Abiraterone plus placebo and 50% of patients to Abiraterone plus Enzalutamide. Both arms in Stage 2 also get Prednisone to go with the Abiraterone. Stage 2 is double blind so neither doctor or patient know which arm you are in. Also in Stage 2 they do not do PSA tests but track the tumour w
  20. AR-V7 is an androgen receptor variant which, if found in the blood stream, disables the effectiveness of either Xtandi/enzalutamide or Zytiga/abiraterone acetate. I have prepared a summary of recent research about AR-V7 which is available at http://tinyurl.com/qbgpezo [Ed - Chuck's paper mentions blood tests for Circulating Tumour Cells (CTC) and AR-V7. These tests are not routinely available in Australia.]
  21. Thanks to Chuck Maack for drawing our attention to the report of a recent presentation by Dr Oliver A Sartor who was the principal North American investigator for the clinical trial that led to the approval by the United States Food and Drug Administration (FDA) for radium 223 (brand name Xofigo). In 2013 the FDA approved radium 223 for treatment for patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. Dr Sartor said that determining whether or not a patient had symptoms of bone metastases could often be a grey area.
  22. A good article in today's Australian Financial Review (16 April 2014) about the 2 Clinical Trials for Enzalutamide that are currently recruiting.
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