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Darolutamide is even Newer than Apalutamide And has fewer side effects. In the US it cost about $12,000 a month but insurance pays almost all of that. I’m on Medicare And this year the maximum you can pay is $2000 for all your drugs. This year I paid $2300 in January and then never paid anymore for any drugs for the rest of the year. That’s how Medicare works.
There is a reason you go on Zytiga before lutamides. If you go on Zytiga first You can then go on one of the lutamides and have a good chance that it will work for another few years. It doesn’t work in the reverse, Going from a lutamide to Zytiga Almost always fails.
I went from 2.5 Years of Zytiga To Darolutamide And now after a little over a year I’ve been undetectable for a year. With Zytiga I was undetectable for one month in that 2 1/2 years And my PSA kept jumping all over the place
There’s a link to an article in the Lancet about The best sequence of using the Drugs.
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30688-6/abstract?mc_cid=c2dca8aa74&mc_eid=99575fc699
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Thanks for sharing the link. The Lancet article is specifically about treating mCRPC, while I have mCSPC (so far), but it's still good information to have. The TITAN study, which was specifically for Apalutamide with mCSPC, ended after 4 1/2 years without reaching median mortality, even after factoring in people whose cancer became prostate-resistant during the study period.
I'm pretty happy that ADT + Apalutamide have kept my PSA undetectable (< 0.01) for over three years (and that I tolerate them as well as could be expected), but I know not everyone will have the same experience.
* For new forum members: mCRPC = metastatic castrate-resistant prostate cancer; mCSPC = metastatic castrate-sensitive prostate cancer; ADT = Androgen Deprivation Therapy (blocking testosterone production) like Orgovyx or Lupron; Apalutamide is a second-generation androgen receptor signalling inhibitor (blocking testosterone uptake by cancer cells) sold under the brand name "Erleada".