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Darolutamide Monotherapy

Posted by mmacaulay @mmacaulay, Jun 12 10:08am

I’m curious about the FDA’s June 5 approval of darolutamide (Nubeqa) as a monotherapy for mCSPC. My understanding is that the AR blocker would allow higher T than ADT while providing protection against recurrence in metastatic cases that were previously treated with ADT. It may even delay the onset of CRPC. Higher T might improve quality of life.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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jeff Marchi | @jeffmarc | Jul 3 12:54pm
In reply to @proftom2 "I started Darolutamide (Nubeqa) Tuesday (7/1/2025). My Stage 4 Advanced Prostate Cancer diagnosis was 12/2020, PSA..." + (show)
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I started Darolutamide (Nubeqa) Tuesday (7/1/2025). My Stage 4 Advanced Prostate Cancer diagnosis was 12/2020, PSA 100+, extreme lower back pain, and bed ridden. Triplet therapy first six months, Radiation, Chemo, ADT. Took about 2.5 ADT years for my PSA to go low, in the 1's. PSA Never undetectable levels, but good enough for me not to worry about 24/7. Very livable. PSA Started slow rise over the last year+. Oncologist put me on Pluvicto, PSA kept rising. He took me off Pluvicto after 4 shots (24 weeks) and switched me over the Darolutamide. Really I am in the transition phase of treatment changing, normally takes a few months, 2-3 labs to see if it works. I also start Radiation again today, first radiation consultation today, very comfortable with radiation. Transformation begins for me when my PSA starts a downward trend. 4.7 Years on this path and still grateful and joyful.

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I hope they can find and zap the metastasis that are causing your PSA rise.

I suppose you got a PSMA pet scan. How many metastasis did it find? Some doctors feel that just zapping those is all you need to do. Hopefully that works for you.

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proftom2 | @proftom2 | Jul 3 1:36pm

Hey Jeff, PSMA Pet Scan, showed 5 mets-spots that need Zapping. Hope, agreed, hope at this phase comes naturally.

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jeff Marchi | @jeffmarc | Jul 3 5:50pm
In reply to @proftom2 "Hey Jeff, PSMA Pet Scan, showed 5 mets-spots that need Zapping. Hope, agreed, hope at this..." + (show)
Profile picture for proftom2 @proftom2

Hey Jeff, PSMA Pet Scan, showed 5 mets-spots that need Zapping. Hope, agreed, hope at this phase comes naturally.

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The maximum they like to zap is five Metz, so you are in a perfect spot. Hopefully, they can zap all those turkeys and your PSA will drop significantly. Let us know what’s happening.

I know someone who had many more than five zapped. He went back a few times and did pretty good as a result

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