Switch from inital Firmagon to Lupron... - Advanced Prostate...

Advanced Prostate Cancer
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Switch from inital Firmagon to Lupron with PSA rise

Jost-58
Jost-58

I have switch from an inital 240 ml injection of Firmagon to in 20 Nov to Lupron.

Lupron will be my long-term ADT by advice from my doc.

After the initial injection of Lupron 19 days ago I can see PSA rise from 87 to 107.

My inital PSA was 1030 13 Nov 2018.

Is the latest Rise due to T-flare on inital Lupron injection. It may take some more time for it to work efficient.

Does anyone have experience of how long it takes before Lupron making good response.

It is diffuclt for me to analyze the trend in this moment with ADT drug switch.

3 Replies
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Get your T tested

Hi Jost,

There is an initial flare in testosterone levels with the Lupron type drugs (Eligard, Zoladex, etc) whereas there is no testosterone flare with Firmagon. The Lupron type drugs are agonists whereas Firmagon is the only FDA approved antagonist. An agonist produces an action whereas an antagonist opposes that action.

Common practice, at least where I live, is to give Casodex (bi-calutamide) pills prior to receiving Lupron injections to lessen the effect of the testosterone flare. Uncommon practice is to use Firmagon to reduce the flare and then switch to Lupron. You might want to ask your oncologist why you didn't remain on Firmagon until your testosterone reached its lowest nadir and then switch to Lupron. It takes two or three months to become completely castrate. Hope that helps.

Why were you switched to Lupron (Leuprolide) from Firmagon (Degarelix) ? Firmagon would seem to be better for long-term PSA and Testosterone control. See study below where people were switched the other way to their benefit.

ncbi.nlm.nih.gov/pubmed/246...

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