1. < Prostate Cancer
Profile picture for sriddle1

Nubeqa (Darolutamide) versus Zytiga versus Estradiol Patches

Posted by sriddle1 @sriddle1, 1 day ago

Does anyone have experience with these two drugs?

My partner was recently prescribed Zytiga along with Orgovyx plus a 7 week radiation treatment.

I have read that Nebeqa may have less side effects and therefore asked the MO if she could change the Zytiga to that. She replied and said, “ Darolutamide/Nubeqa is not approved in this scenario. (And it's never been shown to be better or have fewer side effects than abiraterone/zytiga).” I’m not sure what the scenario my partner has that wouldn’t allow for him to have it and I of course will wait to ask her more questions in person as this was all through messaging portal.

My question is, are these two drugs not somewhat the same thing? I know of course they’re different but wanted to know if anyone knew why he wouldn’t be able to take it.

I also asked about the possibility of him taking Estridiol instead of ADT and her reply was, “ I have used estradiol patches, it has its advantages but does increase risk of thrombosis (blood clots) so I haven't used them together with radiation. There is also of course more breast side effect (enlargement and sensitivity). So they are a good choice for some but not all.”

I’m somewhat disappointed I guess as I had hoped he could take the Nubeqa instead. I have read a fair amount on it and most what I have understood is that it seems to be better tolerated.

Does anyone have experience with using Estradiol patches instead of the ADT route?

Thank you for any advice or tips. I’m just trying to navigate this whole situation the best I can with the most knowledge.

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

Profile picture for sriddle1
sriddle1 | @sriddle1 | 23 hours ago
In reply to @jeffmarc "@sriddle1 The question comes down to is he castrate resistant! Since he has not been treated..." + (show)
Profile picture for jeff Marchi @jeffmarc

@sriddle1
The question comes down to is he castrate resistant! Since he has not been treated yet, he is castrate sensitive, not castrate resistant.

If still castrate sensitive, then it is approved for metastatic disease, which he apparently has. I did say that it was approved for all castrate sensitive people.

Jump to this post

@jeffmarc, correct. He is (I’d assume) castrate sensitive.

REPLY
Profile picture for northoftheborder
northoftheborder | @northoftheborder | 22 hours ago
In reply to @sriddle1 "@northoftheborder , maybe that’s her issue? Cost, her kickbacks, etc. I am still waiting and seeing..." + (show)
Profile picture for sriddle1 @sriddle1

@northoftheborder , maybe that’s her issue? Cost, her kickbacks, etc. I am still waiting and seeing how I approach. I’d really like to know why she said, “it’s not approved in this situation.”

What ADT medicine did or do you take? How are/were the side effects now that you’re off Zytiga? Or did they just remove the Prednisone?

Thank you

Jump to this post

@sriddle1 I was on steroids to try to bring down the swelling in my spine. I was lucky enough to start on Apalutamide right away in 2021, since the TITAN study had just demonstrated a dramatic benefit from starting ADT and Apalutamide together for my situation (metastatic castrate-sensitive prostate cancer — mCSPC), and my oncologists were tracking the latest research.

For ADT, I started on monthly Firmagon injections, then moved to Orgovyx when it became available in Canada in early 2024 (it's basically the same as Firmagon but in daily pill form — big quality of life improvement over the injections).

I'm pretty sure you can't take Zytiga without Prednisone, but I'm not writing that fron personal experience.

REPLY
1 reply
Profile picture for jeff Marchi
jeff Marchi | @jeffmarc | 21 hours ago
In reply to @northoftheborder "@sriddle1 I was on steroids to try to bring down the swelling in my spine. I..." + (show)
Profile picture for northoftheborder @northoftheborder

@sriddle1 I was on steroids to try to bring down the swelling in my spine. I was lucky enough to start on Apalutamide right away in 2021, since the TITAN study had just demonstrated a dramatic benefit from starting ADT and Apalutamide together for my situation (metastatic castrate-sensitive prostate cancer — mCSPC), and my oncologists were tracking the latest research.

For ADT, I started on monthly Firmagon injections, then moved to Orgovyx when it became available in Canada in early 2024 (it's basically the same as Firmagon but in daily pill form — big quality of life improvement over the injections).

I'm pretty sure you can't take Zytiga without Prednisone, but I'm not writing that fron personal experience.

Jump to this post

@northoftheborder
You are correct you cannot take Zytiga without prednisone. Zytiga eliminates the cortisol a body produces, it is a critical drug you need in your system. Prednisone puts the cortisol back.

One main problem someone has without cortisol is extreme fatigue. That’s why some people need more than the 5 mg standard prednisone given with Zytiga, They still have fatigue and may need 7 1/2 or 10 mg. Any of those are standard doses for prednisone with Zytiga

REPLY
Profile picture for ucla2025
ucla2025 | @ucla2025 | 21 hours ago

My husband has been on Orgovyx and Nubeqa for 5 months and they are working well so far. His situation sounds very similar to your husband’s. His info. is in my profile if you’re interested. His only side effects of the treatment have been hot flashes and a bit of fatigue, nothing that keeps him from doing normal activities or has affected his health otherwise. We requested the Orgovyx/Nubeqa combo right at the start and had no problems getting either of them. Nubeqa has a co-pay program which requires one payment of $300 and then no more co-pays for a year. Our Blue Shield covers the Orgovyx. My understanding is that both of these drugs are newer and are therefore more expensive but they are much better than the older ones in terms of side effects. Maybe you should ask your doctor for a more detailed explanation of why she won’t prescribe this drug combo. We had no problems getting them through our UCLA oncologist.

REPLY
1 reply
Profile picture for sriddle1
sriddle1 | @sriddle1 | 20 hours ago
In reply to @ucla2025 "My husband has been on Orgovyx and Nubeqa for 5 months and they are working well..." + (show)
Profile picture for ucla2025 @ucla2025

My husband has been on Orgovyx and Nubeqa for 5 months and they are working well so far. His situation sounds very similar to your husband’s. His info. is in my profile if you’re interested. His only side effects of the treatment have been hot flashes and a bit of fatigue, nothing that keeps him from doing normal activities or has affected his health otherwise. We requested the Orgovyx/Nubeqa combo right at the start and had no problems getting either of them. Nubeqa has a co-pay program which requires one payment of $300 and then no more co-pays for a year. Our Blue Shield covers the Orgovyx. My understanding is that both of these drugs are newer and are therefore more expensive but they are much better than the older ones in terms of side effects. Maybe you should ask your doctor for a more detailed explanation of why she won’t prescribe this drug combo. We had no problems getting them through our UCLA oncologist.

Jump to this post

@ucla2025, thank you. I have messaged our oncologist pretty much demanding he have the Zytiga switched to Nubeqa. I will report back.
I was going to ask if your husband was advised any radiation and have just read his status.

Thank you for your reply. All very helpful to me.

REPLY
View MoreView Less
Please sign in or register to post a reply.