Decrease Nubeqa?

[Sweetjessie]

I'm 83, prostate cancer(PSA 30) with negative bone scan, negative MRI, but PET shows multiple small mets throughout both lungs and multiple lymph nodes throughout the chest. Started with 600 mgm bid of Nubeqa, and Orgovyx 120 mgm once a day. I also received radiation to the prostate approx. 6 months after diagnosis. My renal function was slightly low, and I was placed on Farxiga 5mgm/day, by a nephrologist, who was not concerned about my borderline GFR.

My GFR is stable, but my oncologist decreased my Nubeqa to 300 mgm bid. I was not having side effects from the Nubeqa. Any thoughts?

[Tall_Allen]

If your GFR comes back to normal, you will know it was the Nubeqa, and you can decide then.

[Sweetjessie]

Thanks for the reply. You may not have fully understand my question. I'm concerned that since the GFR is only slightly lower than normal, I'd prefer to have the full dosage of the Nubeqa(the nephrologist was not concerned about the Nubeqa damaging the kidneys).

[RoseDoc in reply to Sweetjessie]

Probably best to have this discussion with your physicians rather than a group composed of mostly lay people.

[Sweetjessie in reply to RoseDoc]

Thanks--I'm sure you're right.

[TJS-1]

My 2cents - the generally prescribed dose from Nubequa trials is 1200mg/day (600mg 2x/daily with food). The prescription insert states dosage should not reduce below 600mg/day (300mg 2x) as effectiveness below that dosage is not established. Reading between the lines, trials probably escalated from 600 to 1200 in phase 2 for toxicity. I have not looked for or read any trials summaries for Darolutamide, but I’m currently on it as monotherapy for almost 2 years now.

I’m a smaller person who prefers to ingest minimum effective drug doses rather than max tolerable. I tapered off to the lower 600mg/day dose last year (300 2x/day with food) and have the same effectiveness I had for the full prior year @ 1200mg/day (PSA undetectable @<.01).

My very limited and anecdotal experience is that 600mg/day is sufficient and effective.

[Sweetjessie in reply to TJS-1]

Thanks so much. I never thought about reading the insert! I weigh around 150 lb, maybe a little bit above a "smaller person". I'll be meeting with my oncologist in 8 weeks, and hopefully my PSA will continue to be near zero. Thanks again for your comment!

[j-o-h-n]

Hey Jessie, Did you ever discuss Keytruda with your doc regarding your lung issues?

BTW The women used to call me Sweeterjohn now they call me Sweatingjohn.

Good Luck, Good Health and Good Humor.

j-o-h-n

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

Thanks a lot--I'll check it out.