So, Dr. Scholz. We're here in 2021, and we're excited about it. There are lots of new things
happening on the horizon, but there are also lots of things that happened in 2020 and obviously,
socially we had a lot of ups and downs, but in prostate cancer, a lot of new things came out
to help patients—not just within certain specific situations, but also across the board.
So, we have some new products that have come out and I'm so excited to discuss them today.
One of the first ones we have is Orgovyx. So, this is a hormone therapy,
and can you explain what it is and also where we will see this take place in the staging?
So, think of Orgovyx like a Lupron in the form of a pill, and Lupron blocks out all the testicular
testosterone that men produce and, as we all know, low testosterone causes cancer to shrink away.
Orgovyx is approved for men with advanced prostate cancer, although, I could see how it might have
application in early stage prostate cancer. It has an attractive component that is different than
Lupron, and not just that it's a pill, but also, the recovery of testosterone when you stop the
treatment is more predictable. One of the issues with Lupron is you tend to have lingering low
testosterone levels, sometimes for many months after the shots wear off. So, this new medicine
might be an attractive agent for men that are newly diagnosed although it's not approved for
that yet. It'll certainly be attractive for men with advanced disease who want to do intermittent
therapy and want to get their testosterone back after the course of therapy finishes.
So, you mentioned it's a pill and Lupron is traditionally a shot that happens over,
you know, a different series of months. What would be—is
there going to be a greater benefit then of just taking a pill and is this just going
to be simpler for patients or what are the attractions of Lupron against it?
So, I think the anti-cancer effects will be the same and some men may prefer to get a shot every
3-6 months so they don't have to take a pill every day. Other people don't like needles
and they may be attracted to the idea of being able to take a pill and get the same benefit.
So, what about patients with heart issues? I know that we had a patient where he said his
doctor suggested that he take Orgovyx instead of Lupron because he had some heart issues,
and I know I've also gotten questions regarding Eligard and Firmagon in these same categories.
So, what do you think about that?
So, the study that compared Orgovyx to LHRH, Lupron type medications, although it was not
testing specifically for the incidence of heart problems, it seemed like the group of men that
were treated with Orgovyx has a lower incidence of heart problems. There wasn't a high incidence
of heart problems because, you know, that wasn't the primary reason to be in the trial,
but there was a lower incidence. So, it does make sense, I think, to consider using this medicine in
people that have predisposing problems: diabetes, hypertension if they're overweight. Lupron and its
analogues have been safe and effective for years, but we know that when you take testosterone away,
men can start putting on weight. It can make their blood pressure worse; It can make their
blood sugars worse, and I'm not sure why they're seeing this pattern of Orgovyx reducing the
likelihood of heart-related issues, but until proven otherwise, it seems to be a real factor.
So, what about when it comes to insurance. I know that, you know,
Lupron seems to widely covered. Do we expect that Orgovyx would be covered in this same fashion?
So I think at this time, it'll be covered for people with metastatic disease. I don't know
how easy it will be to get coverage for people who are newly diagnosed. We'll just have to see.
So, how will Orgovyx compare with Lupron and Eligard, and Firmagon in terms of side effects?
Yeah, I think the only other difference from Lupron, as similar to the sort of Firmagon
type drugs, is that Orgovyx doesn't cause any testosterone flare when you start it up. So,
when you give Lupron, there's a couple of weeks where the testosterone goes up and
we take precautions—we give people Casodex or some other medication to cover for that. Firmagon
causes the testosterone to drop precipitously and there's no flare, and Orgovyx is that way as well.
So, if there's a situation where people are nervous about a testosterone flare,
Orgovyx has an advantage in that regard.
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