Erleada (apalutamide) vs Orgovyx (relugolix)

Erleada (apalutamide) and Orgovyx (relugolix) are both used in the treatment of advanced prostate cancer, but they work in different ways. Erleada is a nonsteroidal antiandrogen that blocks the effect of androgens (male hormones), which can slow the growth of prostate cancer cells, while Orgovyx is an oral gonadotropin-releasing hormone (GnRH) receptor antagonist that directly lowers testosterone levels, a key driver of prostate cancer growth. When deciding on the appropriate medication, it is important to consider factors such as the specific stage of prostate cancer, potential side effects, drug interactions, and whether the convenience of an oral medication (Orgovyx) outweighs the need for more frequent monitoring compared to a medication like Erleada that is also taken orally but may have different monitoring requirements.

Difference between Erleada and Orgovyx

Metric	Erleada (apalutamide)	Orgovyx (relugolix)
Generic name	Apalutamide	Relugolix
Indications	Non-metastatic castration-resistant prostate cancer (nmCRPC), metastatic castration-sensitive prostate cancer (mCSPC)	Advanced prostate cancer
Mechanism of action	Androgen receptor inhibitor	Gonadotropin-releasing hormone (GnRH) receptor antagonist
Brand names	Erleada	Orgovyx
Administrative route	Oral	Oral
Side effects	Fatigue, hypertension, rash, diarrhea, nausea, weight loss, arthralgia, falls, hot flush, decreased appetite, fractures, peripheral edema	Hot flush, increased glucose, increased triglycerides, musculoskeletal pain, decreased libido, erectile dysfunction
Contraindications	Pregnancy, severe hepatic impairment	Pregnancy, known hypersensitivity to relugolix or any components of the product
Drug class	Nonsteroidal antiandrogen	GnRH receptor antagonist
Manufacturer	Janssen Biotech	Myovant Sciences

Efficacy

Introduction to Erleada (Apalutamide)

Erleada (apalutamide) is a medication that has been approved for the treatment of prostate cancer. Specifically, it is indicated for the treatment of non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic castration-sensitive prostate cancer (mCSPC). Apalutamide works by inhibiting the action of androgens, which are male hormones that can promote the growth of prostate cancer cells. By blocking the effect of androgens, Erleada can slow the progression of the disease and may help to delay the spread of cancer.

Efficacy of Erleada in Prostate Cancer

The efficacy of Erleada in treating prostate cancer has been demonstrated in clinical trials. In a pivotal phase 3 trial known as SPARTAN, patients with nmCRPC who received Erleada experienced a significant improvement in metastasis-free survival compared to those who received a placebo. The median metastasis-free survival was markedly extended in the Erleada group, highlighting its potential in delaying disease progression. Additionally, Erleada has been shown to have a positive impact on overall survival in patients with mCSPC when used in combination with androgen deprivation therapy (ADT).

Introduction to Orgovyx (Relugolix)

Orgovyx (relugolix) is another medication that has been approved for the treatment of advanced prostate cancer. It is an oral gonadotropin-releasing hormone (GnRH) receptor antagonist that works by reducing the production of testosterone, a hormone that can fuel the growth of prostate cancer cells. Orgovyx is specifically indicated for the treatment of adult patients with advanced prostate cancer and is the first oral GnRH receptor antagonist for this condition, offering a non-injectable treatment option for patients.

Efficacy of Orgovyx in Prostate Cancer

The efficacy of Orgovyx in the management of advanced prostate cancer has been established through clinical research. In the phase 3 HERO trial, Orgovyx was found to be effective in achieving and maintaining castration levels of testosterone in men with advanced prostate cancer. The trial demonstrated that a significantly higher proportion of patients treated with Orgovyx achieved sustained testosterone suppression to castrate levels compared to those receiving leuprolide acetate, a commonly used injectable GnRH receptor agonist. This has important implications for patient convenience and quality of life, as well as for the management of advanced prostate cancer.

Regulatory Agency Approvals

Erleada

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia

Orgovyx

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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