Good News Story from Australia: Apalutamide to become available on PBS for men living with mHSPC

[marnieg46]

Prostate cancer treatment worth $40,000 a year to be listed on PBS

 A significant prostate cancer treatment is about to become more affordable for men across the country. 

Men living with metastatic hormone sensitive prostate cancer will be able access Erlyand (apalutamide) on the Pharmaceutical Benefits Scheme (PBS) from June, a drug which currently costs patients about $40,000 a year. 

This specific cancer effects about 3000 Australian men and apalutamide has proven to boost survival rates.  Currently two in three men with stage four prostate cancer in Australia do not survive.   The PBS will reduce the cost of the drugs to $A30 per script, or about $A7.30 for pension card holders.   

Professor Anthony Joshua at St Vincent's Hospital said prostate cancer uses testosterone to fuel its growth, which was why men were given hormone injections. "Then the cancer realises there is no testosterone around anymore and it starts to make its own testosterone and that's what these drugs are very good at blocking," Joshua said."These class of drugs are very effective in helping men live longer and live better." 

Federal health minister Mark Butler said the PBS listing would make a dramatic change for men and prostate cancer suffers."It is a treatment that can be taken at home without attending a hospital or other medical facility," Butler said. This is the first drug of its kind to be listed on the PBS for men whose cancer has spread. Last year it was subsidised for those with earlier stage disease.

Prostate cancer is the most diagnosed cancer in Australia and the second most deadly. 

[Hidden]

Another step in the right direction. Best of luck.

[marnieg46 in reply to Hidden]

Yes great news for those that haven't become castrate resistant.

[ARIES29]

Thank you for this information, I will run it by my MO next week.

[Sailing-Todd]

As the wife of Sailing-Todd (Very metastatic HSPC at start of journey last April) I cannot recommend Apalutamide highly enough.

[j-o-h-n]

Good News.....Thank you....Now you guys should stop selling Kangaroo meat labeled Lamb cause it causes us Americans to play HipHop music. (and I hate hip hop music)....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 05/27/2023 10:04 AM DST

[marnieg46 in reply to j-o-h-n]

As I'm totally devoid of anything that resembles a sense of humour I've asked the boy to think up something that resembles a smart response...hopefully it's printable!! If he can't think of a match he'll probably blame cognitive impairment caused by the ADT or the Abi...

Trust you're doing well 😊

[j-o-h-n in reply to marnieg46]

No one is totally devoid of a sense of humor........You got married, correct?.... I rest my case....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 05/27/2023 8:58 PM DST

[d3is4me in reply to marnieg46]

Marnie love you reply sure hope he replies May be we should sell them Crocodile for Barramundi

🦘

[marnieg46 in reply to d3is4me]

Thanks Ross. He’s trying to think of something witty. It’s a very slow process these days.

j_o_h_n has always got a clever answer doesn’t he!! Such a bright light on a depressing topic .

I’ll PM later. Was thinking of you when I posted as I guess it won’t alleviate the cost of Abi will it!!

Hope all goes well in sunny QLD ….up the Blues! Hope those Maroons don’t hurt my Latrell 😉

[d3is4me in reply to marnieg46]

Marnie I understand I am the same

[j-o-h-n in reply to marnieg46]

To my little Lolly marnieg46,

BULLETIN: South Sydney superstar Latrell Mitchell has sensationally fired some early warning shots across the bowels of the Queensland Maroons.

Now for the weather forecast: All day tomorrow HOT AND DUSTY followed by 7 years of the same. Attention - Vacationers, Visitors and Jail Escapees..... Government Umbrellas for sale..

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/28/2023 8:00 PM DST

[j-o-h-n in reply to d3is4me]

Sounds sort of fishy to me................

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/28/2023 7:41 PM DST

[MateoBeach]

Good news indeed, Marnie. To have another powerful and affordable tool in the toolbox. Paul

[marnieg46 in reply to MateoBeach]

Yes Paul, good news for those wanting to access it who haven't been able to either find someone to prescribe or alternatively if they have afford the ongoing cost.

Interesting that Professor Joshua was mentioned in the article as a few weeks ago I was tempted to respond to one of Patrick's posts on the other hub. The article he posted mentioned common drugs that might be of benefit, one was Indomethacin and the other that came up in the article was Metformin.

Back in April 2019, after RP and adjunct radiation in later 2015/ mid 16, Ron's PSMA showed numerous node and bone mets, his urologist referred him to Prof Joshua for a trial he was conducting using two common drugs - one was a drug to fight fungal infection and the other indomethacin. Ron didn't qualify for the trial due to the aggressive nature of his condition but Prof Joshua wrote to Ron's urologist strongly recommending he immediately commence on Abiraterone or Enzalutamide and Metformin. An interesting recommendation at the time as neither Abi or Enza were SOC for men who hadn't progressed on ADT... and I might add still aren't in Australia and also Ron wasn't pre diabetic so Metformin would have seemed a bit unusual to prescribe.

We had no luck with Ron's Urologist who just dismissed the report and prescribed Lupron...and then some seventeen months later... became as you know castrate resistance as would be expected. As an aside.... in mid 2021 when Ron's psadt was going up at rate of knots over five months the same doctor suggested we "keep our powder dry and not start Enza or Abi"

To cut to the chase...I've never forgotten... how at the time back in 2019, I couldn't help thinking that Professor Joshua was at least ahead of the pack and in some way knew, for most men with aggressive disease, the SOC recommended at the time (ADT alone) would not be sufficient to avoid castrate resistance in the short term.

Great to hear your own amazing progress and so well deserved. Definitely an inspiration and trail blazer. I'll write separately. And maybe later this year....who knows...m

[Survivor1965]

Is this different that Enzuludamide?

[marnieg46 in reply to Survivor1965]

Hi Survivor,

There will be others here far more well informed to answer your question than I am. However this article might be of some help:

cancernetwork.com/view/apal....

Why the listing of apalutamide is probably of more relevance for men in Australia with mHSPC is that Abi, Enza... and to date Apalutamide.... are not available on PBS for men who are metastatic hormone sensitive. This means, that firstly you need to find a MO or Urologist who is willing to prescribe off label...which isn't easy...remembering our pool of specialists is much small than in the US or Europe and basically most doctors stick to SOC which often directly co-relates to what is funded by PBS. Secondly, even if you can find someone to prescribe off label the costs are around $A4 000...thinking long term.... each and every month!

In Australia, Abiraterone and Enzalutamide are still only accessible on PBS to men who are castrate resistant. It's very difficult..speaking from past experience... to convince treating physicians to prescribe even when willing and able to pay if someone is still responding, to say Lupron or similar. So that's why the news will be well received by some men wanting to pursue this treatment.

Hope the article is helpful.

[d3is4me]

Marnie Your last replies are great and so true.I was also tempeted to reply to Patricks post re indomethacin it seems you can not mention that word on HU . I will PM you re my experience with indo not related to PC

Have a great day

[marnieg46 in reply to d3is4me]

You too Ross.

[Brianne07]

I will be looking forward to thatHave an appointment with professor joshua early june. That will take a bit of pressure off my budget and stress levels

Regards Brian

[marnieg46 in reply to Brianne07]

You’re very fortunate Brian to be accessing Professor Joshua. I’m not the only one on HU who has found him a leader in the field.

He offered to take my husband on as a patient. However, my husband had already established a rapport and relationship with his urologist and was reluctant to change. A quality that’s a blessing and a curse at times. Water under the bridge now.

[Brianne07 in reply to marnieg46]

Is that a pun " water under the bridge"I have been with him around 17 months and have had a very good result so far PSA down to 00.06

Regards brian

[marnieg46]

Well I didn’t mean it as a pun but I get your point.

I’m sure you’re in the best of hands with Prof J and fabulous that the results have been very positive. Congratulations.

I heard on a podcast earlier this year Louise Emmet also from Vinnies is working hard trying to get Lu 177 funded in Oz. Maybe one day.

[Seasid]

I found the following information about Apalutamide by using the Cancer Copilot of the malecare.org

Apalutamide and abiraterone parallel

Cancer Copilot

Thank you for your question! Apalutamide and abiraterone are two different medications that are commonly used in the treatment of prostate cancer.

Apalutamide is a medication that belongs to a class of drugs called androgen receptor inhibitors. It is used in the treatment of metastatic castration-sensitive prostate cancer, which means that the cancer has spread to other parts of the body and is still responsive to hormone therapy. Apalutamide works by blocking the action of androgens (male hormones), which can fuel the growth of prostate cancer cells.

Abiraterone, on the other hand, is a medication that belongs to a class called androgen biosynthesis inhibitors. It is used in the treatment of metastatic castration-resistant prostate cancer, which means that the cancer has spread to other parts of the body and is no longer responding to hormone therapy. Abiraterone works by blocking an enzyme called CYP17, which is involved in the production of androgens.

While both medications are used in the treatment of prostate cancer, they have different mechanisms of action and are typically used in different stages of the disease. Apalutamide is used in the earlier stages, when the cancer is still responsive to hormone therapy, while abiraterone is used in the later stages, when the cancer is no longer responding to hormone therapy.

It's important to note that the specific treatment approach for prostate cancer can vary depending on various factors, such as the stage and aggressiveness of the cancer, as well as the patient's overall health and preferences. Therefore, it's always best to consult with your healthcare provider for personalized recommendations.

István Hoffmann

[marnieg46 in reply to Seasid]

Thank you Istvan. A very clear explanation of the difference between the two medications. It will be appreciated by those less familiar these two drugs and trying to understand and make sense of the choice of drugs in their treatment regime.

[Seasid in reply to marnieg46]

Really not easy.

I really love your posts they are great. Thanks very much for helping us out.

István