Switching from Lupron to Orgovyx.
Doing 6 months ADT and considering switching from Lupron to Orgovyx for my second 3-month period. Have any of you done this? If so, I would be interested in hearing about your experience.
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You are correct in my case. I qualified for Neubeqa As an add-on to Lupron and Docetaxel
which is the triplet therapy (and I also received Carboplatin). All this was followed by Pluvicto. I know Lupron is in the gonadotropin-releasing hormone (GnRH) analogue family of medications. It works by decreasing gonadotropins and therefore decreasing testosterone and estradiol and I think Orgovyx is too,it just won’t linger in the bloodstream like the injections do. Nubeqa is an Androgen receptor pathway inhibitor. It is my hope/prayer that I can regain a normal level of testosterone in my bloodstream for the other normal functions of my body and that the Nubeqa will still block the testosterone at the cancer receptor site. I hope that all makes sense.
I can sure understand your hopes a prayer on that one. Something I am going to add to my talking points book for my future treatments.
That below 20 issue is exactly what I contacted my oncologist about. My testosterone has slowly Creeped up to 25 from below five. It’s a pretty fast doubling rate for 8 months. You would think that after seven years of Lupron, it would not start rising so quickly. I did take Orgovyx the last eight months, but that’s still a pretty quick rise.
The thing is, even though I stopped it the hot flashes are as annoying as ever.
Are you on bone strengtheners now? If you are on ADT is it highly recommended that you take bone Strengtheners like Fosamax, Zometa or Xgeva. Was in a webinar a few months ago, where a doctor who specializes in bone conditions was really emphatic about the need to do this.
I am a third of the way through my first 6-month ADT cycle with 25 sessions of salvage radiation. At this point I presume "we" don't know where I stand in regard to long term treatment.
Everybody is so differentthere’s just no way to know what your future is.
No, I'm not on bone meds. At this time my doctor considers me a short timer on ADT until we find out otherwise. This is my first round.`I also weight train and mountain bike which helps bang the bones for bone strength. I'll probably get there eventually.
Also not on any bone strengtheners. Just now getting into the ADT regimen and not sure if it will continue or let the Lupron die off to see where my T and PSA are at that point. I'm now just saying no to Lupron and yes to an oral medication if I need to go back on an ADT. Getting advice soon from an oncologist.
But, as mentioned, I'd like to have a bone density check first, for a baseline.
First I've heard of this one. I have a sit down with my oncologist 4/1 /2025. Sure like to do something rather than nasty Lupron. I quit my second session 2/18/2025 due to SE's First session quit 3 years ago again, horrible SE's. Now only Prednisone plus Abiraterone both have SE's How bad? hard to tell as Lupron is still lurking in my blood stream. Would be great to be able to quit both and go with Nubeqa only.
Many thanks,
SW
Orgovyx shuts down T quicker and the half-life post treatment is much less. I am currently 2 months in on lupron and so far SE's are a mild headache midafternoon and some fatigue.
The Lupron shot you've had will take some time after its advertised shelf life to clear your system.
I personally don't see any issue in switching, what does your medical team say?
As to mono-therapy with an ARI, yes, that is a possible option. Supporting data for that comes out of the EMBARK trial so discuss that with your medical team.
I'm off treatment now. When, not if, I go back treatment I intend to have that discussion with my oncologist. It should be interesting as he swears we'll do 24 months ADT + ARI and SBRT (the EMBARK trial has as an arm the 24 month ADT+ARI).
I also will discuss the PATCH trial which uses an trans-dermal estrogen patch vice ADT.
As to being on bone strengthening agents while on ADT, yes and no. My general understanding is one should have a baseline bone density scan. For those on longer term ADT, possibly, short term, less so. There is also resistance training which can be a factor in mitigating the bone density impacts of longer term ADT.
Kevin