Apalutimide

[Drphil1938]

Is apalutimide a possible replacement for Lupron or Zytiga and prednisone? If someone knows please respond, thank you!

[pjoshea13]

Apalutimide is a direct alternative to the other "lutamides" (Bicalutamide, Enzalutamide, ...) which are all antiandrogens.

Antiandrogens are sometimes used as monotherapy, without ADT.

-Patrick

[Tall_Allen]

Erleada (apalutamide) is currently approved for metastatic hormone sensitive PC or non-metastatic castration-resistant PC. If you are metastatic and castration-resistant (PSA increasing while on Lupron ) and Zytiga has failed too, you will not be able to get the drug (although I've seen some oncologists work magic with insurance companies). You will be able to get Xtandi. You might try extending the life of Zytiga with a switch from prednisone to dexamethasone.

[MateoBeach]

Apalutamide (Erleada) has some compelling distinct advantages when added to "standard" ADT. The SPARTAN trial established this for non-McRPC and led to it's approval. Expect the indications to expand.

This article was published today:

(See the additional links at the bottom for further information)

renalandurologynews.com/hom...

[tkalaf]

Thank you for this link Mateo. As I've a personal interest I've found this news of interest.

As a participant in trial clinicaltrials.gov/ct2/show...

I undertook combined amounts of ADT and HT medicines. I won't go into it here, but the experience was intense. Amongst this kitchen sink of medicines was Apalutamide, which was just approved for clinical-trail use only. I took pills and injected ADT over the Spring of 2018, then had my RP surgery in June. Since then, I've been getting my PSA tested. So far, its' been reported below threshold. Thanks again, and best of health to all!

[Fairwind]

Are you doing any ADT now ? If so, what form ?

[Drphil1938 in reply to Fairwind]

Yes, my treatment consist of , three mo. Lupron injections and daily Zytiga with prednisone. My thought was to get rid of Zytiga and prednisone. I don't like the prednisone side effects. Also, the survival expectations seem to be higher with apalutimide.

[Drphil1938 in reply to Fairwind]

Also, my last test showed T below 5 and PSA dropped from 2.8 to 1.7. I am 6 months into this SOC. Started with 470 of T and 99 PSA

[JoelT]

It should not be considered a replacement for Lupron. The clinical trials and the approval includes primary ADT with drugs like Lupron simultaneous with aaa (Erleada)