We had one patient -50
year old gentleman diagnosed with hormone refractory prostate cancer. His PSA
was 100 ng/ml with multiple bony metastases and iliac and paracaval
lymphadenopathy with left ureteric obstruction.
He had locally advanced prostate
disease with hematuria.We treated with High Intensity Focussed Ultrasound(HIFU) to control the local disease and left ureteric stenting.We also started him on docetaxel chemotherapy
with prednisolone support.He did not show good response ; his PSA came down
only to 90 ng/ml. We started him on Xtandi and
were planning for samarium radio-isotope therapy for bony pains but he did show
remarkable symptomatic as well as PSA improvement with Xtandi( after 1 1/2 months the PSA was 75 ng/ml).For now we have
dropped our plans for samarium therapy.
Enzalutamide is an androgen receptor inhibitor
that acts on different steps in the androgen receptor signaling pathway.
Enzalutamide has been shown to competitively inhibit androgen binding to
androgen receptors and inhibit androgen receptor nuclear translocation and
interaction with DNA. A major metabolite, N-desmethyl enzalutamide, exhibited
similar in vitro activity to enzalutamide. Enzalutamide decreased proliferation
and induced cell death of prostate
cancer cells in vitro, and decreased tumor volume in a mouse
prostate cancer xenograft model.
XTANDI
is indicated for the treatment of patients with metastatic castration-resistant
prostate cancer (mCRPC) who have previously received docetaxel. U.S.
FDA Approves XTANDI(R) (enzalutamide) After Priority Review for Patients With
Metastatic Castration-Resistant Prostate Cancer Previously Treated With
Docetaxel.
XTANDI is provided as liquid-filled soft gelatin
capsules for oral administration. The recommended dose of XTANDI is 160 mg (four
40 mg capsules) administered orally once daily. XTANDI can be taken with or
without food.
The most common adverse
drug reactions (≥ 5%) reported in patients receiving XTANDI in the randomized
clinical trial were asthenia/fatigue, back pain, diarrhea, arthralgia, hot
flush, peripheral edema, musculoskeletal pain, headache, upper respiratory infection,
muscular weakness, dizziness, insomnia, lower respiratory infection, spinal
cord compression and cauda equina syndrome, hematuria, paresthesia, anxiety,
and hypertension.Xtandi is specially contraindicated in epileptogenic patients.
The efficacy and safety of
XTANDI in patients with metastatic castration-resistant prostate cancer who had
received prior docetaxel-based therapy were assessed in a randomized,
placebo-controlled, multicenter phase 3 clinical trial. The primary endpoint
was overall survival. A total of 1199 patients were randomized 2:1 to receive
either XTANDI orally at a dose of 160 mg once daily (N = 800) or placebo orally
once daily (N = 399). All patients continued androgen deprivation therapy.
Patients were allowed, but not required to continue or initiate glucocorticoids.
The pre-specified interim analysis at the time of 520 events showed a
statistically significant improvement in overall survival in patients on the
XTANDI arm compared to patients on the placebo arm
My father (aged 57, a doctor by profession) was diagnosed with Prostate Cancer in 2009. He has been put on Zytiga since June 2012 and had been responding very well. However, his PSA has started rising again and we are looking for a source for Xtandi. Could you please share some information on where it is available in India. Thanks, Nishant (nishantbajaj28@gmail.com)
ReplyDeleteThanks for sharing the information about the A promising drug for chemorefractory disease .
ReplyDeleteImpotency solution ,premature ejaculation treatment,solution to erection problem
آموزش دیجیتال مارکتینگ
ReplyDeleteمحتوایار
سئو
طراحی سایت
طراحی سایت
ReplyDeleteطراحی سایت در رشت
طراحی سایت فروشگاهی در رشت
طراحی سایت در انزلی
طراحی سایت در رودسر
طراحی سایت در لنگرود