NUBEQA (darolutimide) as MONOTHERAPY (no lupron or similar)?

[Gl448]

I’ve seen two posts today in a couple of threads stating that they’re currently on NUBEQA, or will soon be as a monotherapy without first line ADT like casodex or Lupron.

One gent says after 7 months he’s got testosterone levels of 700 with undetectable PSA and no progression on scans.

Another says he’s going off the casodex soon for NUBEQA.

Not sure yet if they’re talking about holidays or more. Anyone else out there on similar protocol?

I’d sure like to hear more about this, and any studies supporting this. Dumping Lupron would be a fantastic improvement in QOL…

[Tall_Allen]

I'm not sure that it improves the QOL or works as well. But that is what the European trial will determine:

clinicaltrials.gov/ct2/show...

Nubeqa potently blocks the androgen receptor, so testosterone, having nowhere to go, accumulates in the serum. I expect that, like Casodex monotherapy, it causes gynecomastia , baldness, and fatigue, but worse than Casodex, as enzalutamide monotherapy did:

thelancet.com/journals/lano...

Similar trials have been run for monotherapy with abiraterone.

nature.com/articles/s41391-...

Apalutamide monotherapy was inferior to ADT+abiraterone:

ejcancer.com/article/S0959-...

[Gl448 in reply to Tall_Allen]

Great information. I assumed you'd lose the low-testosterone effects of Lupron.

Thanks, as always!

[Trivista]

Iam on Lupron and will be for life. And I have also added Nbequa 14 months ago.

Gleason 9. RP 2015.

PSA was rising even on Lupron. Trend was not my friend. So Doctor at Dana Farber prescribed Nubequa after a PSMA scan was negative. PSA slowly dropped. VA Paid for Nubequa as I am 100% service connected. Trend is now down.

[JolleySprings in reply to Trivista]

How quickly did your PSA drop once you started NUBEQA??

[Trivista in reply to JolleySprings]

It was down in 3 moths and continues to trend lower every 3 months with each blood test. It has gone from 1.7 to .19 in a year. thw 1.7 reading was a doubling move in 2021. With a Gleason 9 I didn't take any chances. I wasn't interested in monitoring it as it climbed higher. So, the trend is my friend right now.

[tarhoosier]

I have been on Enzalutamide monotherapy for 6.5 years. Gynecomastia is moderate and other side effects are minor or associated with ageing. Oncologist suggested it as zoladex was not a problem. I can resume Zoladex/degarelix at any time if psa requires.

[GP24 in reply to tarhoosier]

The Embark trial results will be published this year. This tested enzalutamide monotherapy versus enza + lupron.

[Derf4223 in reply to GP24]

EMBARK is studying non-metastatic patients. With every trial, please look to inclusion criteria first to gauge relevance to this group.

[j-o-h-n]

Went off casodex in late January 2023 and starting nubeqUa tomorrow, Thursday, 03/09/2023. As far as I know I will still be on Lupron......

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/09/2023 6:45 PM EST

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

How is the Nubequa working for you??

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

Only side effects are that I'm tired (sleeping more) and shortness of breath....Cardiologist is checking the shortness of breath but I'm sure he won't let me run out before all my bills are paid.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 08/13/2023 1:08 PM EST