Here's another plot summarizing data from a 2020 paper in the New England Journal of Medicine by Neil Shore, et al. that shows Orgovyx has much faster "ON" and "OFF" changes in testosterone levels, compared to Lupron.
This plot compares the percentage of men who recover their testosterone (defined as T > 280 ng/dl), after 90 days of stopping ADT treatment. Only 3% of men on Lupron had "recovered" their testosterone, compared to 54% of men on Orgovyx who had "recovered" their T, both at 90 days after stopping ADT treatment.
These results explain why Intermittent ADT (iADT) is not particularly successful for men taking Lupron (i.e., their T-recovery is too slow). Doing iADT with Orgovyx would be expected to work much better, because Orgovyx has a much faster T-recovery when stopping Orgovyx at the beginning of the "OFF" period (Holiday).
The idea of rapid changes to the cancer environment is very intriguing. As with BAT, Cypionate has a longer half life, putting less stress on the cancer as it washes out of the body. Propionate like Orogovyx, washes out quickly, stressing the cancer more. Researchers are aware of this but putting it to the test may never come to pass.
There is also the thought that the lingering effect of testosterone (and tumor) depression/suppression with Lupron produces a better result than Orgovyx's flipping testosterone back on almost immediately. I considered this, and I am still thrilled to be on Orgovyx....for another 35 days, 18 hours and 16 minutes.
One of the arguments used by RO in refusing to order orgovyx for use with RT? 18 months of ADT with Lupron = 18 months of Orgovyx + X ? additional months of Orgovyx;p
This chart shows median values. There's a tremendous variation (Bell Curve distribution) of T-recovery times among men who were on ADT for the same duration. You might be one of the men in a tail of the distribution.
The recovery time also depends on your age and baseline T. Higher baseline T and a younger age would likely have a shorter T-recovery time.
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