Xtandi Is Improving Health And Survival in Prostate Cancer
- Xtandi is advancing treatment for late-stage prostate cancer, enhancing longevity and wellness.
- Xtandi targets prostate cancer cases deemed high-risk due to aggressive disease characteristics, such as rapid PSA increases after prior treatments.
- By blocking male hormones, Xtandi slows or even stops the cancer’s growth.
- Its broader application, both by itself and in combination with other treatments, has made it a game-changer for treating prostate cancer.
In simple terms this refers to individuals whose prostate cancer has returned after initial treatment and tests show a rapid increase in PSA levels, indicating a higher risk of the cancer metastasizing (spreading).
Read MoreRelated: How to Treat Late-Stage Prostate Cancer
Who can benefit from Xtandi?
Xtandi is indicated for four types of prostate cancer stages:
- Nonmetastatic Castration-Sensitive: Early-stage cancer that might spread and still responds to hormone therapy.
- Metastatic Castration-Sensitive: Advanced cancer that has spread but still responds to hormone therapy.
- Nonmetastatic Castration-Resistant: Cancer that hasn’t spread but doesn’t respond to hormone therapy.
- Metastatic Castration-Resistant: Advanced cancer that has spread and doesn’t respond to hormone therapy.
Xtandi’s approval for men with newly diagnosed, hormone-sensitive metastatic prostate cancer means that it is suitable for patients whose cancer has spread and responding to treatments that lower testosterone.
This expands its use to earlier in the treatment journey, offering a potential option soon after diagnosis for those with advanced, hormone-sensitive disease.
“And so that is a practice changing study which is already informing my care of my patients,” Dr. Wise says.
Related: Guide to Prostate Cancer: Overview
How does Xtandi work?
Xtandi is considered androgen deprivation therapy (ADT). It acts like a blocker, stopping male hormones, mainly testosterone, from helping prostate cancer cells grow.
By inhibiting the androgen receptor on cancer cells, Xtandi effectively deprives them of the male hormones that fuel their growth. This helps slow down the cancer’s growth and sometimes stops it all together which helps control the spread of the disease.
Xtandi is taken as a pill, usually once a day. Exact dosage and frequency depends on the specific condition being treated and the patient’s overall health.
Like any drug, Xtandi does sometimes cause side effects. Some common ones include:
- Fatigue
- Hot flushes
- High blood pressure
- Musculoskeletal pain
- Diarrhea
Serious side effects are less frequent but can include allergic reactions, seizures and cardiovascular issues.
As for the cost, Xtandi can be quite expensive. Price varies based on insurance coverage and location. Patient assistance programs are available to help cover the costs.
Xtandi is not a cure for prostate cancer. However, it can control it by slowing the progression and spread of the disease – often for several years.
Dr. Edwin Posadas, of Cedars-Sinai Medical Center, explains how some men are more at risk for prostate cancer than others.
What do the studies say about Xtandi?
The use of Xtandi is based on the results of several clinical trials that showed its effectiveness and safety.
Most recently, the phase 3 EMBARK trial looked at the best treatment for high-risk prostate cancer that had returned after surgery or radiation.
EMBARK enrolled 1,866 men from 26 countries and followed them through treatment from 2016 until 2023.
The trial compared how well Xtandi worked by itself or when taken along another hormone blocker called Lupron (leuprolide). The goal was to determine which method did the best job of delaying the spread of cancer and increasing how long patients stayed alive and healthy.
- The trial found that Xtandi plus Lupron reduced the risk of metastasis or death by 61% compared to other treatments.
- Even when used by itself, Xtandi reduced the risk of metastasis or death by 41%
- Both Xtandi combinations delayed disease progression and the need for new anticancer therapy
Other studies show that Xtandi can also be used with other drugs that target specific mutations or pathways in the prostate cancer cells, such as olaparib or abiraterone.
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