Xtandi vs Erleada

[Magnus1964]

Can someone explain the difference between Erleada and xtandi? My research doctor tells me they are chemically very close. So since I am currently on xtandi, Erleada is not an option.

[Longterm101]

It’s my understanding they are all a “me too” drug

TA to verify

[Tall_Allen]

Erleada is approved by non-metastatic castration-resistant PC (non-mCRPC) and for metastatic hormone-sensitive PC (mHSPC). Xtandi is approved for metastatic castration-resistant PC (mCRPC) (it will probably be approved for metastatic hormone-sensitive PC very soon)

To summarize the FDA-approved use of new hormonal agents so far:

non-mCRPC: Erleada, Nubeqa, Xtandi

mHSPC: Zytiga, Erleada

mCRPC: Zytiga, Xtandi

Xtandi, Erleada, and Nubeqa are anti-androgens. They block the androgen receptors (AR) to prevent the cancer cell from getting activated. They also prevent the AR from translocating from the cell surface to the inside, where it wouldn't need any outside androgens for activation. Erleada stops AR amplification - another of several causes of anti-androgen resistance. All of them seem to be about equally effective, although there has never been a head-to-head test.

[Magnus1964 in reply to Tall_Allen]

Thank you T-A, I was having problems with this. Now I need to do some more research.

[Xtandiuser in reply to Tall_Allen]

Thanks for your clarification, Tall Alllen! 👍

[LearnAll]

They are both members of Lutamide family...drugs which inhibit AR receptor.

Xtandi = Enza LUTAMIDE.

Erleada = Apa LUTAMIDE

Nubequa = Daro LUTAMIDE

Their Older brother is Bica LUTAMIDE All of them work by same mechanism of action.

Its just like Adam's family...famous Lutamide family....

[Magnus1964 in reply to LearnAll]

Thank you, that adds to T-A's explanation. Now to crank up Google scholar..

[Magnus1964 in reply to LearnAll]

It is interesting that I have been on casodex, zytiga and xtandi. All have provided me with years of extended life.

If this family of drugs work on the same mechanism how is it that I received a fresh boost from each? I am talking about significant benefits from each. Casodex 5 years, zytiga 3 1/2 years and xtandi 3 1/2 years.

If each provided years of benefit then others in the "family" may provide more years.

[LearnAll in reply to Magnus1964]

Magnus,,

Zytiga is not in Lutamide family. Its a single, lone member of its own.

Zytiga has a very unique mechanism of action. Zytiga blocks an enzyme called CYP17,,,which is necessary enzyme to produce testosterone in all the three sites viz. testicles, adrenal gland and cancer cells themselves ,

As for why a second lutamide can.work after first has run its course, I have a hypothesis ::

After a long time gap, if you subject the cancer cells to the same old type medicine, it again starts killing them . The cancer cells have forgotten how to work around the medicine. So it feels like a new treatment. Also, after long time gap, the cancer cells are new ones and the old ones have already died..the once who knew how to work around the old medicine.

Based on this assumption, I believe Bicalutamide may still work again for you, just like Enzalutamide, Apalutamide or Darolutamide. There are some difference in degree and type of side effects in various lutamides but fundamentally they are similar.

[Hidden in reply to LearnAll]

Thanks so much. Xtandi and zytiga are so expensive is there any way to make the cost more reasonable.

[Hidden in reply to Hidden]

Go on the Zytiga web site and there is information on helping with cost. Right now we pay a $10 a month co-pay.

[Hidden in reply to Hidden]

Thanks - Good news if I need it.

Are you taking it?

[Hidden in reply to Hidden]

Yes, my husband started it last month. Don't know what will happen when he retires as the co-pay is only if you have insurance.

[LearnAll in reply to Hidden]

There are 4 lutamide meds available now ( bicalutamide, enzalutamide, apalutamide and darolutamide) The competition will grow in coming months and years causing price drop.

Zytiga price has come down in USA from $12000 a month to $2400 a month ,

In Europe $500 to $700 and in India $100 to $150 a month.

Luckily, my copay is only $10 so I am OK with using my insurance for zytiga.

[Magnus1964 in reply to Hidden]

You can get it from India. Some one else posted the information

husband took Zytiga for his first month on this medication at an insurance co-pay of $2328.25. The second month he took the generic, abiraterone acetate, purchased in India. Three bottles were $260 a piece, the next four were $320 a bottle, supposedly due to an added government tax. We talked with Mr. Singh in New Delhi, India, and completed our entire order through WhatsApp. Our shipment arrived at our front door in five days. Mr. Singh answers his phone and sends and receives text messages day and night. Contact information: EMEDKIT, Mr. Singh, phone number [phone]. Medication info: abiraterone acetate tablets, 250 mg., 120 tablets. Manufactured in India by: Glenmark Pharmaceuticals Ltd. and approved by USFDA. Another participant on this blog replied to me that Glenmark has been in business for 30 years and is approved by USFDA. Our connection to this supplier was passed on to us through our oncologist. We wired $2,096 to Mr. Singh’s company and had constant contact with him from purchase through tracking to our front door. The shipping fee is $36.00. We ordered enough to last through the end of December. I know, a little risky to assume that the drug will continue to work for six months. Positive thinking! Two months ago, my husband’s PSA score was 233. July 1, PSA 0.77.

[tango65]

Dr. Morris at the MSKCC told me that there is not a significant difference between enza and apalutamide. There is a difference between darolutamide and apalutamide or enzalutamide. Darolutamide has a higher affinity for the AR and is not affected by some of the mutations of the AR which makes the cancer resistant to enzalutamide and most probable apalutamide.

"Darolutamide

(ODM-201) is an AR antagonist with higher affinity to the AR

than enzalutamide or apalutamide. It can inhibit mutated

AR (AR F877L, H875Y/T878A, and F877/T878A mutants) associated with enzalutamide resistance "

ncbi.nlm.nih.gov/pubmed/307...

[Rexwaterbury in reply to tango65]

Then why is it not approved for mCRPC? Seems ideal.

[tango65 in reply to Rexwaterbury]

I agree it should be approved.

Best of luck.!!

[tango65 in reply to Rexwaterbury]

It seems to work in pretreated metastatic castration resistant cancers:

sci-hub.tw/https://www.eu-f...

I hope it will be approved soon.

[Magnus1964 in reply to tango65]

WOW I'm getting some great information on my post. Thanks.

[tango65 in reply to Magnus1964]

Best of luck,!!

[j-o-h-n in reply to tango65]

Oops I guess you do know, cause I was one of a few who recommended him to you...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/29/2019 6:02 PM DST

[j-o-h-n in reply to tango65]

You may know that Dr. Morris is my M.O. also.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/29/2019 5:58 PM DST

[tango65 in reply to j-o-h-n]

Best of luck my friend, you are in good hands.

[j-o-h-n in reply to tango65]

You hit the nail on the head....

Speaking of hands...... take a look at the on-line review that I wrote about him...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/30/2019 2:39 PM DST

[monte1111]

What have you done with Magnus? The white lamp is gone. The mustache is gone, well maybe faded. No one your age has that much hair. Most certainly a wig. You, Sir, are an imposter. Enjoy.

[Magnus1964 in reply to monte1111]

My hair turned white and the mustache thinned out due to ADT drugs. I thought I should update my photo.

[lewicki]

Hi, I just returned from second trip to University of Heidelberg Germany. Doing the LU-177 and and actinium 225 combination. 1st trip had good tumor reduction along with major decrease in Psa. Hoping for same results after 2nd treatment. Going back in 5 weeks

[Magnus1964 in reply to lewicki]

Sounds good. All the luck on your outcome.

[VictoryPC]

Before CRPC, xtandi is better. If CRPC about equal.