Darolutimide as monotherapy

[RugbyVLS]

I know there has been a phase 2 trial (EORTC-GUCG 1532 trial) testing the efficacy of Darolutimide as monotherapy and was wondering if anyone outside of the trial has done this. The phase 2 triall seemed to show that it could be very effective in lowering PSA. Since it doesn't actually stop testosterone production but instead just acts as an androgen receptor blocker in cancer cells, perhaps it would have fewer side effects and still act to put to sleep/kill the cancer cells the way traditional ADT does.

[TJS-1]

I’m coming up on a year of darolutamide monotherapy with very good results. We monitor bloodwork and PSA monthly.

[CWT53]

I did seven months as a mono therapy after the better part of five years on Lupron/aberaterone/xtandi. PSA started at a little over one and then jumped to six. Now on docetaxel. I still had a good deal of fatigue and developed some skin rashes, but it wasn’t as oppressive as ADT. My testosterone levels remained low throughout the darolutamide only therapy—due to the damage of long-term Lupron. It all sucks.

[Finlay66]

Does anyone know if Darolutamide works on patients who have failed Enzalutamide? My Oncologist says no but I would be interested in any opinions.

Thanks

[PCaWarrior in reply to Finlay66]

My MO says maybe. They have different resistances.

[Teacherdude72]

While I understand avoiding the side effects of Lupron with Nubeqa I personally choose to do both. Monthly Lupron and Nubeqa for, now starting my third year. PSA is <0.02 since forth month of treatment.My though has been limit the food and limit the ability to eat what ever food there is is the right strategy for my G9 Cancer.

But that said it is a personal choice either way. Diagnosed in late 2015 and now at 75 still exercise and do things. Slower and more rest stops but living and enjoying life.

[Brysonal]

I have had 12 months undetectable PSA and NED scans following going metsstic through the skeleton in late 2021 and 7 months of treatment in 22. I have done 18 months ADT and 12 months Apalutamide and my MO has just agreed for me to try Apalutamide as a monotherapy. I am getting a PSMA PET scan to take a baseline position and no Zoledex is planned in Sept but will continue monitoring and taking my Apalutamide as a blocker

No idea if my testosterone will recover and if it does will my PCa reappear but feel I need to try it.

I’ll follow your journey with interest.

[Benkaymel]

I've been on Prostap (lupron) plus Xtandi for approaching a year with good results (lowering PSA) so far and have wondered if Xtandi monotherapy would be as effective? I would think there would still be many of the same SEs such as fatigue and hot flashes since the uptake of T is blocked everywhere but maybe the genital shrinkage would stop/reverse since production of T would start up again?

[garyjp9]

Does Darolutamide monotherapy after Lupron allow your testosterone to recover just as it normally would, without any drug following Lupron (presumably slowly)?

[AlvinSD in reply to garyjp9]

This is a very intriguing and attractive concept if your testosterone goes up. My last one was <20 and even if I could get my testosterone to 200 I think I’d feel so much better.

[treedown]

Tried to get Nubeqa but Kaiser refused. Xtandi sucked so on Zytiga now and PSA backndown to .04. No complaints but would have preferred to avoid the steroids. Always a chance I will get it in the future.

[Aldo62]

I needed a break from ADT and for 5 months I have been using a darolutamide monotherapy. Testosterone is over 700. Tumors have receded. Monitoring PSA every two weeks and my Psa has been hovering just below 10 .

[Still_in_shock in reply to Aldo62]

I was thinking of doing the same, but was told an androgen receptor blocker blocks testosterone from all cells, not just prostate cancer cells. Not allowing you to utilize your testosterone.

Was I told incorrectly?

[Aldo62 in reply to Still_in_shock]

I think that might be true to a certain extant, but the adverse effects are fewer by far. It does not go through the blood brain barrier, so there are no real psychological effects; no depression, brain fog, etc. It may cause a tiny bit of ED, but nothing like ADT. I have much more energy, no muscle pains. The only thing I have really noticed is a sensitivity in the nipples.