Article: Half dose prostate drugs ‘controls cancer minus side effects

Would gladly volunteer for this study should it find its way to the US. Surprised I'm not hearing drug companies crying foul yet.

Can't read without an account, but there's lots of research happening in this area, both for dosage reductions and for treatment pauses.

The groundbreaker was the 2013 SWOG trial, which showed that ADT holidays were safe for non-metastatic prostate cancer, but (unfortunately) not for metastatic.

The new major trial that's relevant to my situation, LIBERTAS, is revisiting that, now that we have doublet therapy with ARSIs for mCSPC. It's testing whether metastatic castrate-sensitive patients who responded well to doublet therapy with ADT + Apalutamide (Erleada) can safely drop the ADT and rely just on the Apalutamide.

The first survival/non-progression results are due this fall, and I'm watching closely.

1. Good article. Since it took so long for my PSA to start to increase after I went off ADT two years ago, I've wondered if a low testosterone level (rather than zero) might be effective (which is what a lower ADT dosage might accomplish). Of course, I don't intend to make any changes without the recommendation of my oncologist.

2. The director of the program said: "No man should be forced to compromise between survival and their day-to-day wellbeing." That's nonsense! It's a nice goal, but life does not make such guarantees.

3. The link to the companion article https://www.thetimes.com/uk/healthcare/article/cancer-patients-dying-fad-social-media-cures-2zt07tzm9 is sadly a real issue. As that article says, "... more than half of those surveyed 'did not trust' information from scientists about cancer," with TikTok being a major source of misinformation. Also, "... with patients falling victim to those who 'deliberately push unproven treatments or ideas'. The oncologists said that the field was 'losing the battle for communication' in the age of misinformation."

You'd think COVID would have taught some of these people something. But no, it has instead heightened misinformation. As someone on this forum said, "You don't get old by being stupid."

One thing that wasn’t mentioned is that this does not have anything to do with ADT. This is a test based on the use of ARPI drugs, and a lot of those effects are more frequently found with abiraterone Since it reduces this testosterone even further than ADT. Hot flashes don’t happen with the lutamides Because they don’t reduce testosterone. Darolutamide doesn’t cause hot flashes or fatigue with the majority of people using it alone and joint pain is rarely happening.

They will be given either a full-dose or half-dose of four commonly used hormone drugs — abiraterone, enzalutamide, darolutamide and apalutamide

@readandlearn This study doesn’t seem to be testing ADTs, just ARPIs.

@jeffmarc I am not near as knowledgeable about the PC drugs and combos as you are, Jeff..however, in a hypothetical situation where someone has taken ADT ( Orgovyx) for say 18 months and has reached a NADIR of < .01 for a period of time ( high risk Gleason score + high PSA early on) do you think dropping Orgovyx and doing say 1/2 dose of Nubeqa might be advised for someone mid to late 70's or early 80's...just to keep quality of life up to tolerable point ? If PSA begins to rise, perhaps start back on an ADT?

Just dropping Orgovyx would probably be a good thing to try now. Check with your doctor and make sure. Usually, when somebody has gone that long undetectable, they can stop and see if Their PSA will stay down.

You would find that Nubeqa has really no side effects, but can keep your PSA down for a long time. I know a lot of people in their late 70’s and 80s that are only on Nubeqa Because it works so well.

I have been on Orgovyx and Nubeqa for almost 3 years. I stopped Orgovyx For eight months and my PSA still stayed undetectable. I had no side effects during that time. My testosterone kept rising, so my oncologist wanted me to go back on Orgovyx since I have BRCA2.

Get PSA test every three months to make sure your PSA is not rising. Your testosterone should start coming back when you stop Orgovyx

@jeffmarc I've been on Nubeqa for four months. I have intense hot flashes, especially at night. Fatigue is quite noticeable. My oncologist said the first two months are rough but that side effects should lessen after that. Hasn't happened.

I would really be interested in reading this article but can't get past the paywall. Can you supply any other information about the study that could allow me to find info about it elsewhere, such as the study name or the name of the lead investigator etc.? Thanks, Andrew

@bht72
Aren’t you also on ADT? That lowers your testosterone and causes most of the hot flash problems.

Yes, Nubeqa can aggravate the problem, but that usually goes away after a short time.

I had severe hot flashes while on ADT. Nubeqa Has not been a problem at all. After eight years on ADT, my hot flashes are what you would call warm flashes and don’t occur very often.

I know dozens of people on Nubeqa And no one reports hot flashes as a problem.

What worked best for me at night was an Embrlabs.com wave 2 device. You can set it to run all night. I used to have the sheet wet under me when I was sleeping because of hot flashes it stopped them.

A Mayo doctor at last month’s monthly meeting posted this information about drugs you can use to stop hot flashes.