From the Guidelines
Xtandi (enzalutamide) is a highly effective treatment option for patients with metastatic castration-resistant prostate cancer, offering significant benefits in overall survival, pain, and quality of life, as demonstrated in the most recent and highest quality study 1.
Key Points
- Xtandi works by blocking the androgen receptor, preventing testosterone from stimulating cancer growth.
- The standard dose is 160 mg (four 40 mg capsules) taken once daily with or without food.
- Xtandi can be used in several stages of prostate cancer, including metastatic hormone-sensitive prostate cancer, non-metastatic castration-resistant prostate cancer, and metastatic castration-resistant prostate cancer.
- Common side effects include fatigue, hot flashes, high blood pressure, dizziness, and falls.
- More serious but rare side effects include seizures, posterior reversible encephalopathy syndrome, and allergic reactions.
- Regular monitoring with your oncologist is essential while taking this medication.
- Xtandi is typically used alongside other treatments like ADT (androgen deprivation therapy) to maximize effectiveness.
Benefits and Considerations
- The medication has shown significant benefits in extending survival and delaying disease progression in clinical trials, making it an important option in advanced prostate cancer treatment 1.
- Discussions with patients should include the lack of data regarding long-term benefits and the cost of enzalutamide treatment compared with other second-generation antiandrogens, such as abiraterone 1.
- The choice of treatment should be individualized based on patient characteristics, disease severity, and prior treatments.
From the FDA Drug Label
XTANDI is an androgen receptor inhibitor indicated for the treatment of patients with: • castration-resistant prostate cancer. (1) • metastatic castration-sensitive prostate cancer. (1) • non‑metastatic castration‑sensitive prostate cancer with biochemical recurrence at high risk for metastasis. (1)
Xtandi is used to treat prostate cancer, specifically:
- Castration-resistant prostate cancer
- Metastatic castration-sensitive prostate cancer
- Non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis 2 2 2
From the Research
Xtandi for Prostate Cancer
- Xtandi, also known as enzalutamide, is a medication used to treat metastatic castration-resistant prostate cancer (CRPC) [ 3 , 4 , 5 , 6 , 7 ].
Efficacy of Xtandi
- Studies have shown that enzalutamide significantly improves overall survival in patients with metastatic CRPC who have previously received docetaxel [ 3 , 6 , 7 ].
- Enzalutamide has also been shown to delay prostate-specific antigen progression, prolong radiographic progression-free survival, and reduce the risk of skeletal-related events [ 3 , 6 , 7 ].
Safety and Tolerability of Xtandi
- Common adverse reactions associated with enzalutamide include asthenia or fatigue, back pain, diarrhea, arthralgia, hot flush, peripheral edema, musculoskeletal pain, headache, and upper respiratory infection [ 3 , 5 , 7 ].
- Enzalutamide carries a small increased risk of seizures, which appears to be dose-dependent [ 3 , 5 , 7 ].