Is Nubeqa (daralutamide) considered ADT?

[AllenMarco]

I'm taking Nubeqa as a sole agent. Had RP 2007, EBRT 2009, was in a clinical trial at NIH using Xtandi (enzalutamide) and getting Prostvac with success for almost 4 years. When PSA went to 13 and the NIH Xtandi trial ended, my local MO started me on Nubeqa last November. I'm an avid cyclist and dealing with some lumbar spine issues so I thought that my 30% loss of power on a bike and loss of muscle mass in my thighs were due to the back issues or age. However, last week my MO said that the Nubeqa would be causing this. Since my testosterone is still in the low normal range for a man my age (70) I had thought I wouldn't see this as a side effect, but here I am. My PSA is now 1.48 and the MO said I still have colonies of PC that will likely someday require chemotherapy, and most likely be somewhat ADT resistant, but I would still need to receive it in order to get the chemotherapy. I'm sort of confused.

[Tall_Allen]

Nubeqa is a powerful anti-androgen (like Xtandi or Erleada). Anti-androgens block the androgen receptors on your muscle cells, your prostate cancer cells, and every other cell of your body, preventing those cells from replicating. So over time, you will have fewer muscle cells. It is always given with a GnRH agonist (like Lupron) that prevents the testicles from producing testosterone. This is the first time I ever heard of Nubeqa given as a monotherapy.

As cancer cells mutate over time, they will become resistant to anti-androgens and will become super-sensitive to even the smallest amount of testosterone. Testosterone levels should be kept below 20. I doubt that your low/normal testosterone is doing anything for you, since you are blocking it from reaching any cells. ADT promotes cell-killing with radiation or chemo. An interesting compromise you may want to investigate is called "bipolar androgen therapy" alternating between ADT and super-high doses of testosterone. This is potentially dangerous and should not be attempted outside of a clinical trial. You can read about it here:

pcnrv.blogspot.com/2016/09/...

[AllenMarco in reply to Tall_Allen]

Hi. When you say that you doubt my low/normal testosterone is doing anything for me, what about sexual function? The reason I have been using the Nubeqa as a sole agent and not getting Lupron is to be able to maintain sexual function. So far so good....thank you Giddy!

[Tall_Allen in reply to AllenMarco]

What exactly do you mean by "sexual function." If you mean erectile function, you can have erections without testosterone. If you mean "libido" I doubt your low T level is doing anything for it.

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

Nuttin like sexual FUNction......

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 04/14/2020 2:45 PM DST