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Nubeqa Monotherapy vs Dual Therapy with ADT
Prostate Cancer | Last Active: 2 days ago | Replies (18)Comment receiving replies
@northoftheborder
Just do a search on the web for fatigue and apalutamide. This is what I have heard from some people in online forums. If you were attending ancan.org Advance prostate cancer meetings you would hear them recommending people switched to Darolutamide In those cases.
Fatigue is a very common side effect of Apalutamide (often prescribed as Erleada), which is typically used alongside androgen deprivation therapy (ADT). While extreme tiredness is frequently reported, clinical data and user experiences indicate that it can be highly manageable with regular monitoring and lifestyle adjustments. NIH
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@jeffmarc As far as actual cognitive impairment goes, fewer than 10% of patients experienced it on any ADT+a lutamide combination according to one study:
https://dailynews.ascopubs.org/do/mental-health-and-cognitive-toxicities-androgen-receptor-signaling-inhibitors
It does support your general point, that Darolutamide appeared not to increase the risk of cognitive impairment:
ADT alone: 3% risk
ADT + Darolutamide: 3% risk (small increase, but within margin of error)
ADT + Abiraterone: 4% risk
ADT + Apalutamide: 5% risk
ADT + Enzalutamide: 9% risk
Note that they had a paucity of studies to review for Darolutamide (that was a caveat in the findings).
These numbers are very low compared to the impression you might have, but that's what I meant by selection bias: people who have no cognitive issues with ADT + ARSI are much less likely to show up in an online forum or support group looking for help.
And for the small minority who did have cognitive impairment on another ARSI which cleared up when they switched to Darolutamide, they probably felt a general sense of well-being overall once the fog cleared.