Zytiga ,xtandi or erleada

[pj1121]

Kaiser MO plan says will add Zytiga ,xtandi or erleada Been on lupron 2 months, MO now adding zytiga. 2nd opinion from UCSF concurs.

Any opinions why they choose Zytiga I have seen a recent study saying Xtandi or Erleada might be better. Doctor Familiarity, Side effects, keep something back in the Armory in case needed later?

Value your experience and opinions.

Thanks

PJ

[Tall_Allen]

There's never been a comparative trial. But Zytiga->Xtandi may work longer than Xtandi->Zytiga.

[pj1121 in reply to Tall_Allen]

Hey Allen

This is the study I referred to.

Zytiga ,xtandi or erleada comparison for PSA effectiveness >90% <.02

urotoday.com/conference-hig...

pj

[Tall_Allen in reply to pj1121]

Thanks. That's a retrospective cohort study. Like all such studies, it is flawed by patient selection bias - those who got one drug vs another did so because their doctor felt that that particular drug would work for them. It makes no attempt to correct for patient characteristics or the abilities of the doctors. It is predictable that the least common/ newest drug did best. The only way to legitimately compare the drugs is to randomly assign them to patients.

[treedown]

This is my 2nd rodeo. Did Zytiga the first time and tried Xtandi this time and hated it with a vengeance. Back on Zytiga. Feel really good now by comparison.

[Seasid]

If you are still hormone sensitive than I would recommend Erleda. In Australia Apalutamide (erleda) is just very recently approved for hormone sensitive prostate cancer. The advantage is that you don't need prednisolone with it.

TA actually has right that Abiraterone first and than Enzalutamide could last the longest. I personally would start with Apalutamide during HSPC phase.

[Kenny68]

Yes, I’ve been on Lupron 3 times and could not tolerate the side effects; hot flashes, night sweats, brain fog etc etc. I now am in advanced stage and decided I want quality vs quantity. Good luck to you.

[Seasid in reply to Kenny68]

Could you try degarelix injection? I don't really have any side effects at least not short term ones. During my first 2 years I was totally fine. If you exercise you should be fine longer. I had to stop exercise because of COVID. It is difficult to go back once you loose muscle mass.

[Lunbo]

Been on all and got 5yrs. with Zytiga and fewer side effects. Three years with Erleada and Xtandi didn't work for me.. Everyone has different reactions to each. Good luck!