Following Eligard failure with Gosarelix?

[Willydad]

Hi everyone. Gl 9, RP & SR 2010. Began intermittent Eligard 2016. Managed to get PSA below 1.0 and T down to <0.2 three times after coming off of breaks. Feb's readings were 12.2/13.6 (psa/T), up from 0.9/0.9 in Nov/20. Eligard(and Bicalutamide) given in Mar, lowered it to 5.9/7.2 Apr. Bone Scan was clear. CT no cause for concern(apparently) other than new 4mm sclerotic focus in iliac bone. Too small to conclude anything with conventional scans(no PSMA-PETs available without basically leaving the country to get one). Then May levels hit 21.2/14.5. No mention of transferring to an MO yet for possible next level treatments. RO's suggestion is lets try Gosarelix instead. Anyone with experience with this? I'm very physically active, and want to avoid losing this gift as long as possible.

Since joining this group experiencing the same 'griefs' as myself, I've lost the feeling that I'm fighting it alone. Thanks for that!

[Tall_Allen]

If Eligard alone wasn't getting your testosterone down to castrate levels, you can try Gosarelix, But if your testosterone is ≤ 20 ng/dl on Eligard, switching will do nothing for you. I'm not sure of the units you are using for T -was it ng/dl or nmol/L?

[Willydad in reply to Tall_Allen]

Nmol/L. Thanks for responding TA.

[Tall_Allen in reply to Willydad]

I would scrap the bicalutamide first - it may be feeding your cancer and raising your T levels.

[Willydad in reply to Tall_Allen]

Will do. Good advice. Thanks

[Hidden]

Hey Willydad.. good news is to swing again at it , different drugs .

[Willydad in reply to Hidden]

Always thankful for extra swings! Thanks Lulu700

[Hidden in reply to Willydad]

Good luck 👍

[Hidden]

If your testosterone is less than 20 and your PSA continues to rise, you are most likely becoming castrate resistant. If that's the case, switching first-line ADT drug (Eligard) won't change that.

Might be a good time to discuss second-line ADT drugs such as Xtandi, Zytiga, Erleada or Nubeqa. I would definitely dump the Bicalutamide first though and see what happens.

And in my opinion, I do think it's best for you to find a MO.

[Willydad in reply to Hidden]

Thank you for your suggestions and opinion gregg57. Much appreciated.