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Xtandi and Erleada TOGETHER WITH ADT improves outcomes in metastatic Hormone Responsive PCa

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Posted 6/21/2019 9:56 AM (GMT -5)
I’m not an expert on Metastatic PCa, but if I recall correctly, Xtandi and similar drugs are typically used when the cancer becomes hormone resistant. Now some news on using these drugs concurrent with ADT in hormone responsive men.
This presentation was made at the ASCO conference a month or two ago, but I don’t think it’s been mentioned here. This article was just published...

https://www.cancer.gov/news-events/cancer-currents-blog/2019/enzalutamide-apalutamide-metastatic-prostate-cancer

Somebody said...
At a median follow-up of nearly 3 years, men who received ADT plus enzalutamide had a 33% reduced risk of death, with 80% still alive compared with 72% of men treated with ADT plus another antiandrogen drug, reported the trial’s lead investigator, Christopher Sweeney, M.B.B.S., of the Dana-Farber Cancer Institute.

Men in the enzalutamide group also had better clinical progression-free survival (PFS), which the research team defined as the time until the return of disease-related symptoms, the detection of new metastases on imaging scans, or the initiation of another cancer treatment for prostate cancer, whichever came first. At 3 years, 63% of men in the enzalutamide group were alive without clinical progression of their disease, compared with 33% in the standard treatment group.

Posted 6/21/2019 10:26 AM (GMT -5)
Thanks for sharing. I think these kind of article shares on the forum are of high value
Posted 6/22/2019 1:30 PM (GMT -5)

Hello Pratoman,

I love that scientists, across the globe, are working EVERY SINGLE DAY on the "next best breakthrough" for prostate cancer and other health ailments.

Meanwhile, I also love that scientists are finding NEW ways to improve and maximize the efficacy of medications that are ALREADY "on the shelf" --- using them in new ways, combining them with other medications, or using them earlier after diagnosis, for a greater health benefit and IMPACT for the patient.

Thanks for posting this update! The last decade HAS brought steps forward, new advancements, and new medications to the forefront!

With my very best,
CYCLONE ~ Iowa State University
Posted 6/22/2019 3:23 PM (GMT -5)
"In fiscal 2018, Pfizer earned $699 million in revenues from the sale of the prostate cancer drug, Xtandi, in the United States—a rise of 18% YoY on a reported basis and operational basis. According to Pfizer’s fourth-quarter earnings conference call, combining royalty income from Xtandi’s ex-US sales, the company earned ~$1.0 billion from the drug in fiscal 2018.

According to Pfizer’s fourth-quarter earnings conference call, Xtandi is the only oral medication approved by the FDA for both metastatic and non-metastatic castration-resistant prostate cancer. The broad label, increasing adoption by urologists, and the company’s focus to drive the drug’s use in early stages are expected to drive Xtandi’s sales in fiscal 2019."
Posted 6/22/2019 8:49 PM (GMT -5)
Thanks for the link.

I am on IHT and when I’m on HT I tend to use Xtandi for a period of time in addition to Lupron or Firmagon.

(At first I thought the title meant that adding Xtandi and Apalutamide with ADT was beneficial...but it’s not combining both these.....just one with ADT...but each seems to be beneficial with ADT. They are of the same class of drug.)
Posted 6/22/2019 9:32 PM (GMT -5)

Jerry L. said...
Thanks for the link.

I am on IHT and when I’m on HT I tend to use Xtandi for a period of time in addition to Lupron or Firmagon.

(At first I thought the title meant that adding Xtandi and Apalutamide with ADT was beneficial...but it’s not combining both these.....just one with ADT...but each seems to be beneficial with ADT. They are of the same class of drug.)

That’s correct. There were two separate trials, ENZAMET, and TITAN. Each showed benefit using one of the two drugs combined with tradititi9nal HT,
Posted 6/23/2019 3:03 PM (GMT -5)
Xtandi is a good drug, but can make tired. I’m thinking Apalutamide might come with less fatigue and be equally or more effective. Not sure what insurance would say about it...
Posted 6/23/2019 8:39 PM (GMT -5)
So, after three years 80% of men with the added Xtandi were alive compared to 72% of men with standard treatment. That's good, but maybe not breathtaking. I'm not expert at interpreting these studies, but what jumps out at me is this part:

"At 3 years, 63% of men in the enzalutamide group were alive without clinical progression of their disease, compared with 33% in the standard treatment group."

To me that seems very significant, and may be where the potential exists for Xtandi to add many years of survival. Controlling the progression = managing the disease.
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