Androgen Receptor Testing & Treatment

This is a fascinating topic, and I believe that one day Androgen Receptor (AR) testing and treatment will become as commonplace as ER.

Below from my MBC Guide is aadditional information. You (and others) are welcome to request a complimentary copy of the 100+ page booklet by visiting:http://www.inspire.com/groups/advanced-breast-cancer/discussion/ive-sent-over-400-copies-of-my-mbc-guide/

According to Jennifer Richer, PhD, investigator at the CU Cancer Center, "We're on the cusp of a major revolution in the way we treat breast cancer. It's increasingly clear that androgens and Androgen Receptors can influence many breast cancers as well. AR is actually even more prevalent in breast cancer than estrogen or progesterone receptors. Targeting androgen receptors in breast cancer gives us a new way to attack the disease." From: http://medicalxpress.com/news/2014-12-san-antonio-androgen-breast-cancer.html

• Enzalutamide (Xtandi or MDV3100), an Androgen Receptor (AR) Blocker: Just as a large amount of breast cancers are ER positive, a majority of breast cancers are Androgen Receptor (AR) positive.In a study of 2,171 invasive breast cancers 77% overall were positive for AR by immunohistochemistry.Among breast cancer subtypes, 88% of ER+, 59% of HER2+, and 32% of TNBC were positive for AR expression by immunohistochemistry. Similar to ER and PR, AR expression is associated with a well-differentiated state and with more indolent breast cancers.From: http://breast-cancer-research.com/content/16/1/R7

Therefore, it may make sense to therapeutically target Androgen Receptors in AR+ MBC in a similar manner as ER receptors are targeted in breast cancer.One AR blocking drug is Enzalutamide, and as of January 2015, several Enzalutamide Clinical Trials are underway for women with MBC in the USA and overseas.

Hi Romansma. I have been a lurker for over a year now and when I saw that you needed a response from a person with real experience with Xtandi (Enzalutamide), I joined immediately to get info to you. Your profile is pretty close to mine - and when my tissue (also from 2013) was tested for androgen receptors, I was 88% positive. I had already been on the A/A combo, and did not have any success with it. So in Aug. 2014, I got into a trial with Enzalutamide (Xtandi) and Faslodex. I also had monthly Xgeva. At the time, I had extensive Bone mets only and I was beginning to have difficulty walking. I was concerned because I was told that there was a very slight chance of seizure as well as some women experiencing confusion and mood swings while taking Enzalutamide. I was in the trial for 8 months and the only side effect I had was fatigue. Some days, pretty bad fatigue - needing to sleep a couple of hours in the afternoon. Other than that, though, I was fine and had no other issues.

I was scanned every 2 - 3 months. My first scan in December showed a healing of bone mets. I knew it was working because I had no pain at all and was able to walk without any problem. There was a slight enlarging of my right ovary seen on the CT Scan, but a separate PET Scan did not pick up any significant avidity there. So I continued on the trial. Then in Feb. 2015, I was scanned again and both the CT and separate PET Scans showed both ovaries having enlargement and probable metastases. I had surgery to remove the ovaries, and this was confirmed. I was off the trial and went on to another trial which targeted a few of the genetic mutations I was found to have. The protocol was brutal and after 4 months of that, I had more progression - abdominal wall and diaphragm.

As of last week, I began Ibrance and Femara which I had learned so much about already from the thread you had started. Thank you so much for all of your info. I was anxious to get this out to you. I am hoping that if you decide to move on to Xtandi, that you will have great success with it. With the great way it was working for my bone mets, I am hoping the same for you. Good luck with your decision.

Diane

You may want to consider calling 1.800.4.CANCER and having a trained NIH representative run a complimentary clinical trial database search for you for open clinical trials using Androgen Receptor targeted hormonal therapy for mbc. Sometimes when we do our own searches, viable trials fail to appear (for example, a trial search for the condition "metastatic breast cancer" may not reveal a viable trial that appears when a search is done for "advanced solid tumor").

I hope you find an open trial!

Hoping you get the drug asap!

Wow! You're getting the Xtandi, Hope! Glad for you. How great that Hummingbird is sharing her experience. I know you'll keep us posted. Bestbird, thanks for the info on finding trials.

Such good news, Hope! Wow! Wishing the best with this treatment and that you can cut back on the pain meds.

I also wanted to mention again that some women on Xtandi experienced confusion and became very nasty at times, enough to cause them to drop out of the trial. At each of my monthly checks, the trial nurse would turn to my husband and ask him directly if I was becoming moody. I never had any of that, though.

So happy to hear that you'll be getting Xtandi! I hope that you'll avoid any mood swings, and that your fatigue will be readily manageable.

Most of all, I hope you get a very long time frame of good results on it!

Great news! Please let us know how it goes (and praying it goes great!).

Yayyyyy Hope! I truly wish this to be the answer to your hard headed cancer. Good luck on it and keep posting so we know how you are and if xtandi will do the job. Lolll now i sound like the person who uses the rat in the lab. My prayers to you Hope. Hugs.