Update on the Treatment of Advanced Prostate Cancer

Jay Motola Health Pro
  • The treatment of patients with advanced prostate cancer that does not respond to hormone deprivation has been the focus of numerous studies and research funds. A series of medications have become available over last several years whose intent was to provide extended survival for patients with hormonally resistant disease.


    Recently, the results of a phase III clinical study of the drug enzalutamide (Xtandi) have become available.  This study, the PREVAIL study was designed to look at the success that this drug demonstrated in patients with metastatic prostate cancer that has progressed and no longer responded to hormonal manipulation, who have not yet received any intravenous chemotherapy.

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    This study was recently stopped midway through the trial and all the patients who were receiving the placebo were offered the drug, Xtandi. This occurred because the study proved that there was a statistically significant overall survival advantage coppared with patients who were receiving the placebo. Those receiving the medication demonstrated a 30% reduction in the risk of death compared to those taking the placebo. Additionally the patients who were treated with the medication also showed a statistically significant radiographic progression-free  survival advantage (time that the patient proceeded without the evidence of metastatic disease progressing on x-ray studies) with an 81% reduction in risk.  Lastly, the percentage of patients alive who were taking the drug was 72% as compared with 65% of those using the placebo.  


    This drug is different from other medications that have previously been developed for the treatment of hormonally resistant prostate cancer. This drug works on several different steps in the biochemical pathway of androgens.  These multiple targets induce cell death, decreases prostate cancer cell proliferation, and decreases tumor volume


    Given the multitude of drugs that are now available for the treatment of hormonally resistant prostate cancer, expect to continue to hear much more regarding the treatment of this disease and the benefits that these drugs have to offer.

Published On: November 25, 2013