Erleada vs Xtandi - what are the differences?

[westjl2]

In light of the fact that Erleada has just been approved for both HRMPC and Non-MPC, I think it would he helpful to all of us to understand what the differences and similarities are between these two drugs.

I just came off of the Titan Study for Erleada used for those of us with MPC, and so will be watching this with great interest. I was not eligible for the Erleada because I have already been switched over to Zytiga...but Erleada and Xtandi will be potential options for me in the future.

1. Will those who have taken Xtandi but have grown resistant- now get a benefit from Erleada in the future? Or vice versa?

2. Does one drug have less side effects or will they generally be the same?

3. What will the cost difference be?

4. There is a preferred order that these newer drugs and additional Chemo need to be taken in as one may reduce effectiveness of another. We need a flowchart showing the latest and most effective treatment plans for various stages each of us are in.

I am meeting with my oncologist again next week and will be asking her these questions.

But if others have had experience with or have researched these two drugs I would be curious to learn as much as we can.

[ctarleton]

These prescribing information links could be a touchstone for those looking further into such questions.

Xtandi

accessdata.fda.gov/drugsatf...

Erleada

janssenlabels.com/package-i...

[tango65]

Very similar. They may have different side effects. I think apalutamide has less neurological complications, such as seizures than enzalutamide.

ascopost.com/issues/march-1...

[GeorgeGlass in reply to tango65]

erleada has less mental issues than xtandi? and aneurisms and seizures?

[dmt1121]

All of these drugs may have interactions with each other and should be carefully considered by you and your MO as to what is taken and in what order and circumstances.

Good luck.

[rococo]

Excellent questions to ask. Hope there iis any info you get from your onc. or this group that is passed on to us. I know some who failed casodex still got a pos. response from nylutamide or xtandi so these there seems. To be no cross. restance and may be the same for ampulutamide and upcoming daralutamide so these drugs CAN be manipulated before going on to castration adt with lupron. Rocco

[GeorgeGlass in reply to rococo]

I've never even heard of nylutamide before. What's the story on that? What are you trying to say in your message? What sequence of drugs to avoid castrate resistance?

[DonM253]

Excellent question. I’m in the same situatio. I’ve been on xtandi for two years but my PSA is starting to rise. Sorry I don’t have an answer for your question as I am also looking for options.

[monte1111 in reply to DonM253]

Took a peak into your past and I congratulate you sir. You have had an amazing journey. Xtandi has done well for me for 18 months now, although I believe I am in more dire straits than you are. I wish you a long, long journey. Enjoy.

[DonM253]

Yeah...I’m on YouTube talking about my journey to a PCa support group. I hope you do well and find something that brings your PSA under control. My best.

[GeorgeGlass]

I feel the same way that you expressed in your post. I'm tired of people saying to talk to your MO. Most of the time, they are guessing, just like all of us on this website. The companies are not working together and there seems to be no standard progression of treatments, or at what point in the cancer progression. I noticed your post is from two years ago. Have you discerned a logically treatment protocol since then?

[westjl2 in reply to GeorgeGlass]

Hi George. I have been on Zytiga with Prednisone for just over two years now. PSA has started to rise again from a low of 3.1 after 4 months on Zytiga to high of 7.1 a few weeks ago. I still feel good and my CT and Bone scans shown stable bone mets. But PSA rises for a reason and so I am now being watched closely with followups and blood work every 3 months.

My MO has indicated that the next step will be another round of Docetaxel. Or they may just stop the Zytiga for a while before doing anything since that seems to bring the PSA down in some cases.

I was told that the next step after the chemo wears off will be Zxtandi. They are not sure if and when Provenge will fit in but it is also on the list of potential treatments, although it is fairly new to our health System which pay 100% of all cancer treatments. I was told that Erleada is very close to Xtandi so would probably not be considered.

[GeorgeGlass in reply to westjl2]

thanks for the info. I hope your next treatment (chemo) is effective for you. I sort of wish that this site had a library for recommendations so it's not such a guessing game. I think erleada and xtandi can sometimes work one after the other or with chemo in between.