Can Nubeqa (Darolutamide) be used instead of normal ADT drugs for localized PCa?

[Mike58]

Hi all.

Australia has just given the green light to lower the cost of this so-called wonder drug from a staggering $40K (AUD) to a low $30. It seems that this drug has fewer side effects than the usual ADT drugs and from what I can gather does a pretty good job of preventing the growth and spread of PCa.

So my question is; Can we use this drug in place of ADT when we also use RT to get on top of localised PCa?

Also, has the USA subsidized this drug to the extent that Australia has?

Thanks all.

health.gov.au/ministers/the...

[GP24]

The Embark trial showed that Enzalutamide monotherapy works better than ADT only, but Enzalutamide + ADT works even better. urotoday.com/conference-hig...

I think the results with Darolutamide would be similar, if there would be a trial available. I would take ADT + Darolutamide for six months after radiation.

[Mike58 in reply to GP24]

Thanks GP24, It looks like TA has added some further info to all this, with a trial currently operating in Australia. I will check it out.

All the best with your pathway to full recovery.

[Tall_Allen]

There are no data on darolutamide monotherapy, and the EMBARK trial showed that enzalutamide monotherapy is inferior to the combination with ADT. I doubt it would be different for darolutamide.

There is a trial in OZ of darolutamide+ADT+EBRT in very high risk patients:

clinicaltrials.gov/study/NC...

Drugs are free on trials in the US, and I would guess in OZ too.

I don't know that it has fewer side effects.

[Mike58 in reply to Tall_Allen]

Thanks T_A. I'm doubtful that I'm a candidate for this trial but will ask about it anyway. The enormous complexities of all the different drugs, treatments, diagnoses, - I have no idea how you keep up with it all, but we are thankful you do!

[Mike58]

Thanks for your reply. Your comments and that of Neal Shore, just shows the in depth complexity of what we are dealing with. Common folk like me will never get a handle on it all but generally trust our Drs for their "expert" opinions. But it is good to know that plenty of people do understand all this and yet dont have a string of letters after their name.

[binati]

The experience in India of my Medical Oncologist is that Nubeqa has less side effects and generally is well tolerated as compared to Abiraterone and Enzalutamide.

[Ramp7]

Intermittent therapy was used. That aspects intrigues me.