game changer for us high risk guys ? looks like some on this board hav
https://www.sciencedaily.com/releases/2025/10/251019120507.htm
A groundbreaking clinical trial has revealed that adding enzalutamide to standard hormone therapy can cut the risk of death by more than 40% in men whose prostate cancer returns after surgery or radiation.
so this seems to be in use already..what are the side effects ?- they sound similar to all the other ADT stuff...unpleasant..
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Thanks for sharing. Yes, there have been a series of studies over the past decade showing that adding a -lutamide to ADT significantly delays (or prevents) progression and increases overall survival. It's probably the biggest advance in prostate-cancer treatment in recent years.
In my case, it was the TITAN study that convinced my medical team in 2021 to put me on Erleada (Apalutamide) as well as ADT right at the start, instead of saving up the Apalutamide until after the ADT stopped working, which was the older practice (they used to use one treatment until it failed, and only then move on to the next). I'm over 4 years now since my stage-4 diagnosis, and still in full remission.
I saw this article this morning and it’s just a repeat of information we’ve had for many years. I was hoping it was something new, until I read it only discussed ADT plus Enzalutamide.
I’ve probably had the same results with ADT plus Darolutamide.
I started the Titan trial in June 2021 at UCLA. I am G9 CR PC and I was 74 years old when I started in the Titan trial. I was on ADT and Erleada for 6 months then surgery then 6 more months of these drugs. Soon after I started this trial my cancer turned undetectable (now 53 months) and it is still that way and that is wonderful progress for a G9, CR locally advanced PC old guy. The head of the UCLA urology department attributes more than 2 years of undetectable readings to the Erleada drug. It is not a cure for CR G9 but it seems to have given me more time to be around. I am thankful for the treatment and my physicians who got me in the trial as a 74 year old guy.
@hbp I did not know it was Erleada..I tried that with orgovyx and could not tolerate it...oh well so much for that.
I had Erleada and lupron and there were tolerable side effects but manageable That is more than 42 months behind me but it may also be in my future My surgeon anticipated that without Erleada, within a year after my surgery in January 2022, I would be a likely candidate for salvage radiation.
When I was first diagnosed, my prognosis was 4-5 years and I am still undetectable 52 months since that prognosis. Erleada has done good by me
@jeffmarc
yea I tried Erleada early on- it didn agree with me ( at the time) so far the switch to Nubeqa ( with orgovyx) has worked... and nubeqa and erleada do almost the same thing, I think.
(btw, who comes up with those drug names..they sound like radioactive children's names..Enzalutamide-darolutamide...! )
@hbp why did they say 4-5 years?
I suspect because of my age, G9,CR and locally advanced and based upon the SOC at that time which was lupron and either surgery or radiation When I received the 4-5 year prognosis, the Erleada clinical trial was not being offered to me ( and I was older than their guidelines). My surgeon and the head of the urology dept pushed the envelope in my case
@hbp I am happy it worked for you !!
@johndavis60 I think "4–5 years" (or 3–5) was the standard diagnosis for metastatic prostate cancer based on the SEER database. They told me the same when I was diagnosed in 2021, though they soon backed off.
SEER is necessarily backwards facing, so it hasn't fully caught up with major recent advances in prostate cancer treatment, including new drugs like the -lutamides, and new treatment strategies like doublet/triplet therapy (or even just recognising oligometastatic as a separate category that can be treated with curative rather than just palliative intent).
So "4–5 years" is what @hbp and I might have expected a decade ago, not (necessarily) what we can expect in 2025.