Enzalutamide + Lupron

[VanHalen84]

There was a new study released last week to show Enzalutamide + Lupron for high risk patients after RP or Radiation. I had RP 3/22 and PSA rising to .14 by 8/22 when I started Orgovyx and then later Zytiga. I've been having neuropathy side effects from Zytiga and interested if this might be better.

Results of the new study:

Lupron + Enzalutamide = 87% BCR free

Lupron = 71%

Enzalutamide = 80%

Thoughts on this study?

I am meeting with Dr. Chandler Park on Tuesday who is one of the authors. I am possibly switching to him as my oncologist as his office is less than an hour versus my current oncologist is 2.5 hour drive.

oncodaily.com/blog/22534.html

[GP24]

When the PSA value rises after surgery salvage radiation of the prostate bed is the usual therapy which works in most cases. If this fails, you would start ADT.

[Tall_Allen]

In the EMBARK trial, recurrent patients (after RP+SRT) had to have PSADT≤9 months and PSA≥1 ng/ml, which doesn't seem to be your situation.

prostatecancer.news/2023/05...

That said, if switching from Zytiga to Xtandi might lessen your side effects, why not?

[VanHalen84 in reply to Tall_Allen]

Thanks, I didn't have the info on PSA≥1 ng/ml or PSADT≤9 months. I have read that Xtandi has more neuropathy issues than Zytiga. Current plans are to continue my holiday from Zytiga until January to see if my nerve pain calms down.

[PCaWarrior in reply to VanHalen84]

You're welcome.

The study requirements are not always set in stone for individual therapies.

If you can get it, Nubeqa might have fewer sides than Zytiga or Xtandi.

For me, Xtandi was far worse than Nubeqa or Zytiga. My MO told me that the guys on Xtandi in her clinic tend to have fewer side-effects. If the side effects of one ARSI are intolerable, would your MO be open to trying a different one?

Hoping for the best for you!

[SViking in reply to PCaWarrior]

Is Nubeqa covered by Medicare? I am castrate resistant with Orgovyx and Zytiga both failed.

[PCaWarrior in reply to SViking]

It is covered. See if your MO can authorize it. It was approved for mHSPC and nmCRPC.

[Bacana in reply to VanHalen84]

My husband did fine on Zytiga but developed neuropathy on Xtandi.

[PCaWarrior]

urotoday.com/conference-hig...

Ask Dr. Park if he feels that a similar approach is an option for you.

[VanHalen84 in reply to PCaWarrior]

Thanks for this link, couldn't find a complete article on this study.

[Darryl Partner]

Malecare’s weekly newsletter has published several articles about this Sign up for free subscription here: malecare.org/prostate-cance...

[VanHalen84]

Met today with Dr. Chandler Park - MO at Nortons in Louisville, KY. Highly recommend him. He knew the most recent studies STAMPEDE, ATLAS and others and rattled off the stats by heart. Anyone around Louisville and looking for a doc, give him a call. They also got me an appointment in a week!

[Tjc1]

I'm on both those. Xtandi I had to back off to half dose because of neuropathy and total debilitating side effects.Two years later or so my PSA started creeping up and I went to 3 pills then 6 months after that went to 4 pills.

I can tolerate the 4 pills a little better now. But I guess I'll be switching to something else anyway since numbers keep going up.

I also quit making my statins , that helped with neuropathy.

Thomas

[Bacana in reply to Tjc1]

Same here, due to debilitating side effects husband had to back off and restart Xtandi, slowly increasing dosage back up to 4 pills. Side effects not debilitating but still dealing with neuropathy.