In a nutshell
The authors aimed to determine the effectiveness of enzalutamide (Xtandi ) in metastatic (cancer that has spread) hormone-resistant prostate cancer compared to the standard bicalutamide (Casodex) treatment.
Some background
Hormone deprivation therapy is a common treatment used in prostate cancer. It targets the male sex hormones active in prostate cancer, such as testosterone. Some patients stop responding to this type of treatment. This is known as hormone-resistant prostate cancer (HRPC). Bicalutamide is a treatment approved for HRPC that blocks the male hormones involved in prostate cancer cell growth. Enzalutamide is a similar drug that has been approved for advanced HRPC treatment.
Methods & findings
The aim of this study was to compare the effect and safety of enzalutamide and bicalutamide in treating HRPC.
375 patients with mild or no cancer symptoms were included in this study. 184 patients in group 1 received enzalutamide and hormone deprivation therapy. 191 patients in group 2 received bicalutamide and hormone deprivation therapy. The average follow-up time was 16.7 to 20 months.
Group 1 experienced an increased progression-free survival (time from treatment until disease progression) of 15.7 months. This was compared to 5.8 months in group 2. Patients in group 1 experienced fatigue, back pain and hot flushes at a higher rate than patients in group 2. Patients in group 2 experienced nausea, constipation and joint pain at a higher rate than patients in group 1.
The most common intermediate to severe side effects in both groups included high blood pressure, kidney swelling, joint and back pain, difficulty breathing and heart problems. 31% of group 1 patients reported serious side effects compared to 23% of group 2 patients. 1 patient from group 1 experienced a possible treatment-related death.
The bottom line
The authors concluded that enzalutamide could be a more effective treatment option in HRPC with mild or no symptoms compared to bicalutamide.
What’s next?
Discuss treatment options with your physician.
Published By :
The Lancet. Oncology
Date :
Jan 13, 2016
