Abiraterone And Enzalutamide Effect Cognitive Impairment and Depression in Men With Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Speaking with men who have taken abiraterone (Zytiga, ABI) and enzalutamide (Xtandi, ENZA), at Malecare we sometimes hear reports of both cognitive and mood changes brought on by these two drugs. Evaluating these two problematic side effects researchers have confirmed our experience, both of these drugs can cause these symptoms and that more men reported depression and a trend towards an increase in cognitive impairment with ENZA as compared to ABI. If you experience any of these symptoms you should discuss them with your doctor. Don't suffer in silence. J Clin Oncol 34, 2016 (suppl; abstr 5059); Parimi, Eigl, Sunderland, [...]

An Independent Prognostic Tool For Men With Metastatic Castrate Resistant Prostate Cancer Taking The Newer Drugs

We have a number of newer hormone pathway drugs now available to treat men with metastatic castrate resistant prostate cancer (mCRPC). Researchers have shown that prostate specific antigen (PSA) response can be used as a pharmaco-dynamic end-point that may help identify men with early resistance to these new drugs. They found that there is clinical significance of an early PSA response (EPR) during therapy with enzalutamide, abiraterone acetate (AA) and orteronel in mCRPC. The researchers evaluated PSA values at baseline and then 28 days after beginning treatment in men who were recruited from other clinical trials. They defined EPR as a decline [...]

Prostate Cancer drugs cost more in the USA than in other countries.

The cost of Enzalutamide (Xtandi) in the United States is being challenged by Knowledge Ecology International (KEI), a public interest advocacy group.  The average US wholesale price of Xtandi in 2015 was $88 per capsule.   That can add up to $129,000 annual cost per man. There are significant issues related to high costs of treatment. The higher the cost, the more likely that insurance companies will  require pre-authorization to cover the cost of the drug.  That means a man dealing with advanced stage disease is tasked with asking his doctor to spend uncompensated time fighting the insurance company for his [...]

Why I Believe That Xtandi Is Superior To Zytiga

I have been writing in a number of prior blog posts and in answers to comments and questions on the blog that I believe that Xtandi (enzalutamide) is a superior drug compared to Zytiga (abiraterone). A number of people have asked me why I say this, so I have decided to respond to the issue. The phase III trials for both Xtandi and Zytiga were very similar to each other. In both trials investigators measured the percentage of men who progressed or died against placebo. In this very important measurement Xtandi blew Zytiga out of the water. Only 14% of men [...]

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