DEGARELIX/ VS. lUPRON

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BOOGEE
Veteran Member


Date Joined Jan 2012
Total Posts : 572
   Posted 4/5/2013 3:40 PM (GMT -7)   
Snuffy Meyers is now prescribing Degarelix as it has less SE than Lupron.
 
 
http://www.medscape.com/viewarticle/781440?nlid=29742_1001&src=wnl_edit_medp_urol&uac=77552FZ&spon=15
Age 53
2010 PSA's 6.3, 4.7 5.6
RP open Oct -2011
Stage T1c
Gleason 4+3 left side Gleason 3+3 right side
11 lymp/ no mets.
Perineural invasion present
neg. marg.
Path staging (pt1): pT2c: bilateral disease
PSA Post -Op
1.2 11/2011
1.8 12/2011
3.5 1/2012
2-12Casodex Lupron PSA .03,
5/12 PSA <0.1, T-12
CT, BONE, MRI Neg. for Mets.
F-18/FDG showed 1 met.,spine T-11

Oncas
Regular Member


Date Joined Jan 2009
Total Posts : 344
   Posted 4/5/2013 3:55 PM (GMT -7)   
Boog,
 
My understanding is that he is now switching his advanced cancer patients (I am one) from Lupron or Zoladex to Degarelix (Firmagon).  Apparently new studies suggest more significant responses from Degarelix and for the first time it is showing a survival benefit. I switched over yesterday on Myer's recommendation and got a loading dose ( two bullets in the belly.) A bit more painful than the Zoladex routine but I'll grin and bear it if it improves my odds.
 
Jim
DX 1/09 Gleason 8
RRP 3/09 path upgrade to Gleason 9, 2 pos nodes
post surg PSA .6 Samarium trial 10/09
EBRT 40 treatments 3/10 PSA 2.0
MRI, bone mets 5/11
Sloan recommends HT 7/11
Sand Lake confirmed widespread mets 9/11
ADT3 10/11-8/12 PSA 0.01
F18 PET/CT 5/12 bone mets still present, some increasing
6/12 2nd line HT Ketoconazole/leukine as per Charles Myers
12/4 Started Forteo to heal mets

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 2149
   Posted 4/5/2013 7:16 PM (GMT -7)   
And there's no need to protect against the initial testosterone surge with Casodex. One man I know had a reaction at the injection site and had to go back to Lupron.
Allen
•3rd biopsy (4/2010):
PSA=7.3, prostate volume=55cc, 8 of 17 cores G6 5-35% involvement
•SBRT (5x8Gy) at UCLA, 10/2010 at age 57
•PSA since treatment:
+3 mos:3.9 +4 mos:3.5 +7 mos:3.0 +10 mos:3.7 +13 mos:3.6 +19 mos:1.18 +23 mos:1.29 +29 mos:.37
• Side Effects of treatment:
+2 wks: Grade 1 urinary & rectal last 1 wk
+1 yr: Grade 1 urinary last 2 months
no ED

BOOGEE
Veteran Member


Date Joined Jan 2012
Total Posts : 572
   Posted 4/5/2013 8:13 PM (GMT -7)   
Jim,
 
Please let us know how you do on degarelix, as my husband had been on HT inc. casodex and Lupron. He now is taking a break after 1 year . If the time comes he needs to go back on meds. We will be asking for the degarelix.
 
BOOGEE
Age 53
2010 PSA's 6.3, 4.7 5.6
RP open Oct -2011
Stage T1c
Gleason 4+3 left side Gleason 3+3 right side
11 lymp/ no mets.
Perineural invasion present
neg. marg.
Path staging (pt1): pT2c: bilateral disease
PSA Post -Op
1.2 11/2011
1.8 12/2011
3.5 1/2012
2-12Casodex Lupron PSA .03,
5/12 PSA <0.1, T-12
CT, BONE, MRI Neg. for Mets.
F-18/FDG showed 1 met.,spine T-11

Keeping faith
Regular Member


Date Joined Oct 2011
Total Posts : 207
   Posted 4/6/2013 8:45 AM (GMT -7)   
i have done both, started on zolodex now on degarilex. I dont believe the SEs are the reasonn for the switch. in fact I think the SEs with degaralex are worse than lupron/zolodex. in addition to more severe hot flashes and accelerated muscle loss, then is the reaction to the injection. It only comes in one month shots (unlike lupron and zolodex which come in 3 and 6 month shots) very frequently you will get a hot golf ball" growing in your stomach as the injection site turns red, swells and hardens and gets hot. I get a mucm more sever reaction if the shot is on the right side (the golf ball turns into a baseball), we dont know why. But for me it worked whereas zolodex did not. MY PSA is now 0.08, but as i mentioned in an earlier thread, my oncologist is now thinking about putting me on a break (after 7 months) to try to limit the damage that the degaralex is doing to my body
AGE 51 DX 48 GLEASON 4+3
MARRIED, TWO DAUGHTERS.
Da Vinci RRP 10/09- CORNELL
PATH - EXTRAPROASTIC, POSITIVE MARGIN, NEGATIVE LYMPH, NEGATIVE SEMINAL VESICLE.
40 SESSIONS OF IMRT COMPLETED 4/10
PSADT UNDER 3 MONTHS
NaF BONE SCAN IS POSITIVE FOR METS, FROM CRANIUM TO KNEE. STARTED HT ON 3/26/12 CASODEX AND Zolodex. Now on Degarelix
Stage 4

LupronJim
Veteran Member


Date Joined Apr 2013
Total Posts : 1325
   Posted 3/17/2014 1:37 PM (GMT -7)   
Just watched this video which is 27 minutes long and shows a preference for degarelix (Firmagon) over Lupron

www.urotoday.com/212-adt-with-gnrh-antagonists

That led me to a Forum search and this thread.

The only negative as pointed out earlier in this thread seems to be only available at 28 day frequency versus now on 4-month Lupron.

Since we travel every sumemr for 2 months to Calif, that may be a minor issue for me.

That and potentially a bit more pain taking one in ther gut, but thanks to Lupron I now have a lot of gut :}

I guess Dr. Myers switched his patients whose initial PSA>20 or confirmed mets (I inferred this from the video not from Myers' site)

Any second thoughts by those of you who made the switch or were already on Firmagon/degarelix?

LupronJim (maybe Firmagon Jim some day when at least something will be firm:})
65 - DX 64 2/13 PSA 3.68 (6 mo doubling) Gleason 9 (4+5)

T1CN0M1B stage IV w. 7 of 12 cores worst ones 70% right PNI

oligometastatic 5 tumors 1 right sacroiliac, 2 on
T4 & T9.

1st Lupron 4 month 3-28-13, 2nd Aug 1
PSA down was 3.68, 0.68 on 08-08-13
PSA 0.12 02-11-14, T<3,freeT<0.048

Prostate shrunk from 50.4 to 31.6

UF & Shands treating w curative intent, not just palliative.

Post Edited (LupronJim) : 3/17/2014 1:46:30 PM (GMT-6)


BOOGEE
Veteran Member


Date Joined Jan 2012
Total Posts : 572
   Posted 3/17/2014 4:49 PM (GMT -7)   
Faith & Jim,

My husband is due for his second Degaralix injection April 2nd. He so far hasn't had any SE but am certain it is coming.
He had been on Lupron for 1 year then off for 1 year.
He had the 2 usual shots in the abdomen without much effects.
I only hope this will work for him as Lupron has.
Are either of you on any other T-lowering meds. along with the Degaralix

BOOGEE
Age 53 @DX
2010 PSA's 6.3, -5.6 RP open Oct -2011
Stage T1c
Gleason 4+3 left 11 lymp/ no mets.
Perineural invasion present
neg. marg.
Path staging (pt1): pT2c: bilateral disease
PSA Post -Op
Nov/11-1.2 Dec 11-3.5 Dec/11 Casodex Lupron -
Dec/12 stopped HT
PSA <0.1, CT, BONE, MRI Neg. for Mets.
F-18/FDG showed 1 met.,spine T-11
March/14 Again started HT - all scans unremarkable

LupronJim
Veteran Member


Date Joined Apr 2013
Total Posts : 1325
   Posted 3/17/2014 9:53 PM (GMT -7)   
Boogee, I am only on Lupron every 4-months and Xgeva monthly, not triple blockage, nor Avodart.

I have not made the switch to Degarelix yet, but may discuss it when I meet with my medical onco on May 13.

That's why I was probing for some feedback.

LupronJim
65 - DX 64 2/13 PSA 3.68 (6 mo doubling) Gleason 9 (4+5)

T1CN0M1B stage IV w. 7 of 12 cores worst ones 70% right PNI

oligometastatic 5 tumors 1 right sacroiliac, 2 on
T4 & T9.

1st Lupron 4 month 3-28-13, 2nd Aug 1
PSA down was 3.68, 0.68 on 08-08-13
PSA 0.12 02-11-14, T<3,freeT<0.048

Prostate shrunk from 50.4 to 31.6

UF & Shands treating w curative intent, not just palliative.

BOOGEE
Veteran Member


Date Joined Jan 2012
Total Posts : 572
   Posted 3/18/2014 12:55 PM (GMT -7)   
Jim,

I can let you know when my husband has his next appt.
how well it is controlling his PSA.

BOOGEE
Age 53 @DX
2010 PSA's 6.3, -5.6 RP open Oct -2011
Stage T1c
Gleason 4+3 left 11 lymp/ no mets.
Perineural invasion present
neg. marg.
Path staging (pt1): pT2c: bilateral disease
PSA Post -Op
Nov/11-1.2 Dec 11-3.5 Dec/11 Casodex Lupron -
Dec/12 stopped HT
PSA <0.1, CT, BONE, MRI Neg. for Mets.
F-18/FDG showed 1 met.,spine T-11
March/14 Again started HT - all scans unremarkable
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