Orgovyx in the UK

[PSA680]

Good morning brothers - just had my monthly oncology video appointment. One issue I discussed was potential use of Orgovyx (Relugolix) with Enzalutamide instead of Firmagon / Enzalutamide combo I have been on for 2 years. I know it’s used around the world & approved by FDA & taken by many of you guys. I have pretty bad post injection reactions & also suffer from heart disease issues so this drug was of great interest. However, my current treatment is working really well on ‘the beast’!

My oncologist’s view was:

1. Orgovyx (Relugolix) was not approved for use by the National Health Service in the UK. I would therefore need to source & pay for myself. He also said because it wasn’t part of any NHS SoC that may give him issues. Is anyone in the UK on the forum taking Orgvyx but in NHS primary care?

2. He wasn’t aware of interaction of Orgovyx with Enzalutamide- is anyone aware of any data on this?

3. Based on the success of the treatment on my APCa he would really like me to stick with it unless QoL is impacted too much & then he would change me to other NHS approved ADT injections (which seem to have worse cardio SEs).

I’d welcome any thoughts

Thank you

Darren

[Tall_Allen]

Have you considered orchiectomy?

[PSA680 in reply to Tall_Allen]

I do I’d ask about that but that’s no longer part of NHS SoC either- guess I could look at cost of doing it privately

[Horse12888 in reply to Tall_Allen]

TA: Under what circumstances do you recommend this (permanent) solution?

[Tall_Allen in reply to Horse12888]

Anyone who is metastatic and castration-resistant. Also anyone who is metastatic and hormone sensitive who doesn't want to try intermittent ADT.

[Horse12888 in reply to Tall_Allen]

If I find myself in that position, I'll find it hard to make a decision that I could regret if better treatment options come along.

[Tall_Allen in reply to Horse12888]

There is nothing on the most distant horizon that would replace ADT. If there were, it is easy enough to get testosterone replacement therapy.

[Horse12888 in reply to Tall_Allen]

Speaking of people who don't want to try IADT, in your experience, do they base their concern on efficacy, or the whipsawing of their moods, personalities, and overall QoL?

[Tall_Allen in reply to Horse12888]

I think most are hoping that testosterone will recover enough on vacations to give them a respite.

[PSA680]

Many thanks for the reply smurtaw - good luck my friend

[MateoBeach]

Since you are on continuous ADT with Firmagon and are tolerating the shots well, there is no need or advantage to switch to private pay, very expensive Orgovyx. They work the same and both have the more favorable CV risk profiles.

[garyjp9]

Hi, when you go on the estrogen patch, what dose do you take?