2 years since RP with steadily rising PSA. PSMA scan revealed one single pelvic lymph node lit up. Six weeks into Orgovyx with zero side effects. PSA went from 0.42 to undetectable. Radiation and the addition of Nubeqa scheduled for mid-January.
(1) Any information on the way Orgovyx and Nubeqa will interact with one another?
(2) Opinions on stopping meds after 6 months, providing the PSA remains undetectable.
(3) Is the radiation necessary at this point?
The radiation is the actual chance for a cure/durable remission.
(1) Nubeqa is only given with ADT
(2) 2 years of ADT is necessary with positive lymph nodes
(3) The radiation, helped by the hormone therapy, is what may cure you
Orgovyx is one way to have ADT and you can add Nubeqa to that. Both combined work better than Nubeqa alone. In my case the side effects of ADT started after eight to ten weeks.
As there is only one detectable lymph node met, you may get the combination for six months only after radiation. However, follow the recommendation of the RO.
The radiation is necessary if you want to get rid of the lymph node met and live with a low PSA value without ADT after the scheduled time for ADT is over.
Hopefully they are planning to irradiate the entire pelvic lymph node fields with a boost dose to the identified node. Do not accept spot treatment, SBRT, alone. With a very low PSA pre treatment, you might reasonably elect just six months of ADT vs the full 24. You can discuss it.
As for the Nubeqa, it certainly is a good combo. However resistance very often emerges within 24 months. So I have to ask if it should be used at this time and burn through the possible window of effectiveness, vs how much it actually adds to adjuvant ADT after salvage RT? I do not know. Paul
Hi Paul, do you have a link for the drug resistance to nubeqa within 24 months.
(1) Any information on the way Orgovyx and Nubeqa will interact with one another?
I take both and have no problem with them interacting with each other.
My husband has taken Orgovyx for 1 year, Nubeqa for 10 months and also had six rounds of chemo. Side effects have been(excluding the chemo) hot flashes, higher glucose and some fatigue. PSA undetectable for over 6 months now. Has been a life saver i believe
Surprised none mention Pluvicto. Though stalled due to manufacturer's production problems, this PSMA radioligand is far far far better than radiation machine treatments. Best SOC is radioligands. Theranostics. Radiation is 50 year old technology with minor tweaks. I don't want machine based radiation. Cryo maybe. Nanoknife maybe. Immunotherapy possible. Ligandchemo in development. Targetted therapies vs. surrounding tissue damage or whole body chemicals.
Prostatectomy 2016. Biochemical recurrence 3 years later. Firmagon for 6 months. PSA indetectable quick. Suspended & waited for PSA to rise. PSA .7 day of Pylarify PSMA-PET. Two tiny iliac lymph hot spots. Orgovyx now. Less side effects than Firmagon. PSA dropped quick, but .1 now for 6 months. Continue ADT until Pluvicto FDA approves for mHSPC. Would like to add Nubeqa NOW!! Especially since Orgovyx isn't pushing PSA to indetectable. ADT for years, as long as PSA doesn't rise. Side effects minimal.
Original urologist & radiologist wanted to bombard my prostate basin, which would have completely missed iliac lymph nodes. TG for PSMA-PET, and soon PSMA radioligand.
Good luck to us all. Weren't for bad luck I'd none a-tall.
puzzled with Orgovyx 
To PET or not to PET
Is Nubeqa a suitable substitute for Zytiga?
Erleada or Xtandi with Orgovyx, preference one way or the other?
