Failing nubequa mono therapy

[rococo]

when Nubeua monotherapy begins to fail what to do next. Wasn’t doing too good with lupron before Nubeua stopped extending because of side effects. Thinking of adding relugolix to Nubeua because it’s more effective than Lipton or just start relugolix for one month followed by one month of Lipton to see if it’s still effective thus saving relugollix if Lipton fails. Will see med onc this Friday. Any help appreciated and will keep you all informed. Thanks

[rococo]

no clinica trials. Been experimenting with protocol for 20yrs, AA mono before adt. Worked for me

[rococo in reply to rococo]

I might add intermittently when Psa nadair undetected or near it

[cesces]

why serial treatment? Why not several at once?

Also consider bipolar androgen therapy.

[Tall_Allen]

Lupron or orgovyx never really "fail" per se. They continue to suppress testosterone production, which you will always need. Nubeqa, however, can fail to block the AR.

[rococo in reply to Tall_Allen]

hoping the testosterone generated by nubeequa will be reduced by ADT that Nubeua than has to blocki ie.less T better better blocking as I doubt AR receptors have increased ( castrate resistant) in previous high T situation. A rather complex hypothetical. Proof will be in the pudding as I decide the Lupron-relugolix route tomorrow

[rococo]

serial treatment if effective conserves arsenal

[BillyJack25 in reply to rococo]

After 3 years on lupron my PSA started going up. My oncologist stopped the lupron and put me on 240 mg of erleada (apalutamide) which significantly reduced my PSA. However the side effects were too much for me, ie. migraines. Reduced the dose to 120 which kept my PSA low for about a year and 1/2. PSA started climbing again and now I am on both Erleada and Lupron. Will see what happens.

[rococo in reply to BillyJack25]

Lupron should work with erleada. If it doesn’t maybe relugolix which is more effective

[rococo in reply to rococo]

Guess no one can address using Lupron and saving relugolix when Lupron fails or go right to relugolix. Conserving my arsenal has been my stradigy for 20 yrs as you can see in my popular post on sequencing vs combining meds

[MateoBeach]

as rococo suggests, abiraterone +p can be effective as a monotherapy (without Lupron or Orgovyx) as it blocks all testosterone production. Nubequa and similar lutamides just block and modulate the AR receptors so often fail as monotherapy.

Dropping the failing Nubequa and trying an alternative ADT such as Firmagon or Orgovyx could be another path to try and show if truly castrate resistant now. If yes then you could qualify for Provenge and or Pluvicto.

[rococo]

Just possible Nubequa midnight black the lowered dose T with orgovyx. Keeping it as per clinical Stu, No side effects. Still have ampulutaimid and another coming down the pike. Keep on keeping on