Dr. Richard Hoffmann, Ask the Pharmacist, 12/04/12

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New drug to treat late-stage prostate cancer

By Richard Hoffmann

Q: I heard a new drug was approved for prostate cancer. What can you tell me about it?

A: The FDA recently (2012) approved Xtandi (enzalutamide) for the treatment of men with late-stage prostate cancer. Enzalutamide is known as an androgen receptor inhibitor, which works to decrease the growth and spread of prostate cancer cells.

The approval of Xtandi was based upon a large clinical study involving almost 1,200 men with late-stage (metastatic castration-resistant) prostate cancer who had received prior treatment with the anti-cancer drug docetaxel.

Results from this study showed the men receiving Xtandi lived a median of 18.4 months, or nearly five months longer than men receiving a “dummy” medication (placebo).

The most common side effects observed in study participants taking Xtandi were weakness or fatigue, back pain, diarrhea, joint pain, hot flush, tissue swelling, musculoskeletal pain, headache, upper respiratory infections, dizziness, spinal cord compression and pain/numbness in the lower spine, muscular weakness, difficulty sleeping, lower respiratory infections, blood in urine, tingling sensation, anxiety and high blood pressure.

Seizures occurred in approximately 1 percent of those receiving Xtandi.

Xtandi is administered orally in capsule form once daily.

In addition to docetaxel, other medications currently available to treat advanced prostate cancer include Jetvana and Provenge, which like docetaxel are  administered intravenously and Zytiga which is given orally.

According to the National Cancer Institute, an estimated 241,740 men will be diagnosed with prostate cancer and 28,170 will die from this disease in 2012.

Richard P. Hoffmann, Pharm.D., has been a pharmacist for more than 40 years. Send questions to him at 2960 E. Coventry Court, Hernando, FL 34442.