Abiraterone+Lupron vs (Clinical Trial) Apalutamide+Lupron

I was on Lupron and Erleada for 13 months with Robo surgery in the 6 th month. The goal was to keep me alive. G9, CR, locally advanced. It not only worked but the surgery and the meds were manageable, but clearly I would not have done either but for this life threatening cancer. I am now 30 months post the treatment beginning, off of all drugs for 17 months, PSA .01. The manageable side effects were, hot flashes, sleep difficulties, loss of muscle and gained 30 lbs, slight brain fog, but as I said, these were manageable and not as difficult as many people have on chemo. My goal is to live as long as possible and reasonably free of pain. I am now 77. Good luck to you and to all.

My husband is Stage 4 and is on Abiraterone/Zytiga and Lupron. It kept his cancer in remission and his PSA undetectable for three years. Side effects are fatigue and other changes due mostly to the hormone treatment. Sorry I can't comment on your other option.

Thanks hbp and lag for your feedback. It is helpful to hear first hand experiences when faced with a life changing decision. May the good lord continue to bless you and your husbands recovery.

I am on Abiraterone (Zytiga) and Leuprorelin (Eligard) for 18 months and my understanding is that Eligard and Lupron are the same drug, but the Eligard is an injection into the fat in your body whereas Lupron is an injection into the muscle in your body.

At face value of reading journal articles and other available articles, it sounds like Apalutamide (Erleada) has a bit of a better efficacy when compared to Abiraterone (Zytiga), however I don't get a sense that one is remarkable better than the other. It is like purchasing a Honda or a Toyota, they are both good cars, yet the final determination might not be made solely on one set of similar metrics.

My health team (we actually reviewed this last week) is of the feeling that the drop in my PSA to less than 0.1 is largely a result of the Eligard and that the Zytiga is just doing a supportive role. I started just on Eligard with a PSA of 19 and three months later my PSA was 0.4, so we opted to add in the Zytiga for traditional couplet therapy. One can wonder if I just stayed on the Eligard if my PSA would have dropped more, or would it have it leveled out at 0.4, fortunately I'll never know and more importantly it is less than 0.1 as of April 2024.

Side effects are not a walk in the park, but the option to complain or do something about it is a big factor in how you work through these challenges. I chuckle that 12 months ago I complained about hot flashes, today I have the same hot flashes, but I have a coping mechanism, and also have other side effects to deal with like brain fog and overall fatigue.

Just to add on that topic, for a while I found that getting 8-9 hour of sleep was working well, even though I wanted 10, but even with 10 hours of sleep I would wake up tired. Recently I have switched to 7 hours of sleep with an alarm clock and surprisingly I have the same energy levels if I slept more, I get to sleep quicker and spend more time in REM sleep. I think the moral of this short story is that you have to try things out.

Hopefully this helps and please do reach out and keep the faith

I am on Erleda and Lupron and while the side effects are unpleasant they are better than meeting my maker.My psa has been 0.02 or less.I was offered a med ‘holiday’ but passed on that.I am not a risk taker and prefer to follow with my meds.I had compression fractures in 3 vertebrae in February 2024.After spinal surgery I am on the road to recovery.When you’re down you must force yourself to get up and keep going.Things will get better.We live in the present because life is a gift.

Based on the feedback and from doing my own research it appears there is very little difference in the effectiveness and side effects between the two.

Edmond1971 and starman have you considered or tried holistic options like acupuncture or massage to help with the side effects?

I also had RRP, post surgery had a persistent and then constantly rising PSA. Then 34 rounds of salvage radiation to prostate bed. My PSA almost doubled during the 7 weeks of radiation. I then found my self a good Oncologist. 12 months after the salvage radiation PSA had continued to go up and they found metastatic involvement of my right Hilium.
I decide to get into a trial. The Metacure study. It was with Apalutamide (Erleada) and Orgovyx. 6 months of the drugs with radiation to the Hilium ( 5 rounds) at three months in.
My PSA was 13.56 at the start of the trial. One month on the drugs PSA was 0.15. After radiation to the Hilium PSA was 0.01. PSA remained at 0.01 while I was on the drugs. Once I stopped taking the drugs PSA started to go up again. I have had 3 consecutive increases of my PSA in the last three months. I will see my oncologist in a few weeks to discuss further treatment options.
As far as doing the clinical trial, I personally am glad that I did it. Although the outcome was not the what they hoped for I still got a lot out of it and hopefully it helped with the research for a cure. Being part of the trial meant that there were monthly lab tests, monthly visits to the oncologists and more scans than I would normally had.
We are fortunate that there are options for treatment. But I know that can make things even more confusing sometimes. Doing your homework and reaching out to people on this forum is key to making the right decision for you.
Wishing you all the best!

I was also in an Erleada + Lupron 13 month clinical trial for my G 9 CR advanced PC and I am thankful that my urologist/ surgeon recommended it and that I listened. I have been in this trial for 30 months, presently PSA .01.

I m stage 4 too, on Arbiterone/ prednisone/ Trelstar. PSA IS less than 0.01 for 15 months. I eat a lot of MUSHROOMS, cuz it helps keep the PSA low. Two lymph nodes by my pelvis were also affected. Agent Orange created this. Feel tired but after short naps: I do well for normal daily activities. That’s my story so far.