Posted 2/13/2014 1:50 PM (GMT -5)
LSil, the ones you mention are the current frontline ADT drugs. Used in combination they lower Testosterone production (Lupron/Eligard), block the androgen from the cancer cell receptor (Casodex), and lower the DHT (Avodart and Proscar). If these fail, we go to the next line drugs like Zytiga and Xtandi, chemotherapy, and immunotherapy Provenge. The quest of many of the clinical trials is to see what combinations and in what order the drugs can be more effective.
One of the reasons the drugs you have stated are used first is that the FDA develops protocol for the drugs to be used, then Medicare and the insurance companies determine what they will pay for. For example, my uro says I would probably benefit from Provenge. But, in my situation it would be "off label" and insurance wouldn't pay for it. Thus unless I want to cover the $93,000 out of pocket, I must wait until ADT fails and I have mets. Possibly some of the trials in process will influence the FDA to change the label use, but that usually takes a lot of time.