Enzalutamide - not just another new prostate cancer drug

Enzalutamide - not just another new prostate cancer drug

Enzalutamide, or Xtandi, was released to the UK public in 2013 and is one of a new generation of prostate cancer drugs, which decrease how often testosterone connects with an androgen receptor.

Enzalutamide - Method of action

Clinical trials of enzalutamide found that those men with advanced cancer (metastatic castration-resistant prostate cancer or mCRPC) who have previously received docetaxel, had their lives extended by an average of five months. Enzalutamide is an androgen receptor inhibitor acting on multiple steps in the androgen receptor signaling pathway, within the prostate cancer tumour cells (1).

Experts say that the new drug will allow patients, who have failed to respond to hormonal treatments such as Lupron and/or chemotherapy, to enjoy a high quality of life during their final months.

The treatment was launched in England through the Cancer Drugs Fund.

Professor Johann de Bono, Professor of Experimental Cancer Medicine at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said: “Enzalutamide is a much-needed development in prostate cancer treatment, and will provide a new option for the increasing number of men with advanced prostate cancer in the UK. Enzalutamide has already demonstrated a positive impact on quality of life while increasing the lifespan of patients. Its use will bring significant benefits.”

Unfortunately, patients wishing to access it privately faced a bill of around £3,000 a month in 2013.

Side-effects of Enzalutamide:

These include, depression, falls and fractures, back pain, bloating or swelling of the face, arms, hands, lower legs, or feet, blurred vision, chills, difficulty with breathing, dizziness, loss of bladder or bowel control, anxiety and nervousness, painful or difficult urination, pounding in the ears, sore throat, neuropathy, unusual weight gain or loss.Seizure is also a side-effect but in less than 0.6 per cent of cases. All cases were resolved.

In a later article on this CANCERactive Website, Doctors and family members were urged to watch out for signs of depression in men taking the drug. A Nature article (2) stated that 'Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient’s depression.'

Go to: Depression may double with new Prostate Cancer Drugs



1. Xtandi - official patient site

2. Depression and prostate cancer: implications for urologists and oncologists; Christopher F. Sharpley et al; Nature Reviews Urology volume 17, pages 571–585 (2020)



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