Xtandi (enzalutamide) is a medicine used to treat certain advanced prostate cancers. Like Nubeqa and Erleada, it blocks testosterone and other male hormones from helping cancer cells grow. Xtandi is usually taken with testosterone-lowering treatment unless both testicles have been surgically removed. It may also be prescribed before chemotherapy when symptoms are mild or absent, or after chemotherapy if the cancer continues to grow. Your healthcare team will consider the type and stage of the cancer, previous treatment, test results, overall health, and other medicines before deciding whether Xtandi is an appropriate treatment for you.
Xtandi may be prescribed for adult men whose prostate cancer:
Testosterone and other male hormones help prostate cancer cells grow by sending signals through androgen receptors on cancer cells. Xtandi blocks these hormones from attaching to the receptors and keeps the receptors from entering the cell’s command center, where they can turn on genes that help cancer cells survive and multiply.¹˒³˒⁴
By blocking these signals, Xtandi may slow cancer growth, lower prostate-specific antigen (PSA) levels, and delay the cancer from spreading or getting worse. PSA is a protein made by prostate cells that is measured in the blood to help track prostate cancer.
Xtandi is an oral medicine available as a tablet or capsule. It is taken once a day, with or without food, and should be swallowed whole with water.
Do not chew, crush, cut, dissolve, or open the medicine.
Take it at about the same time each day, and do not change the amount or stop taking it without speaking with your healthcare provider.
The ENZAMET study followed men with advanced prostate cancer that had spread to other parts of the body. After five years, 67% of men who received Xtandi with testosterone-lowering treatment lived, compared with 57% of men who received testosterone-lowering treatment without Xtandi.⁵⁻⁷
The PROSPER study found that Xtandi delayed the spread of prostate cancer. On average, cancer took about 37 months to spread in men taking Xtandi, compared with about 15 months in men who did not take it—a delay of nearly 22 months.⁵
A study by George and other researchers included 2,910 veterans with advanced prostate cancer that had spread and kept growing despite very low testosterone. Among men treated with Xtandi or Zytiga, Black men lived about 33 months, compared with about 25 months for White men, after differences in age, health conditions, test results, and cancer spread were considered.⁶˒⁷
These results are encouraging, but they do not prove that race made the treatment work better. However, the studies do show why all men need equal access to the right treatment for their needs and close follow-up during care.⁷
Possible side effects include:
Seek medical treatment right away for:
Fertility
Xtandi may harm an unborn baby. Men with female partners who can become pregnant should use effective birth control during treatment and for three months after the last dose.1-3
Xtandi can interact with medicines used for high cholesterol, high blood pressure, blood clots, seizures, infections, and other health conditions. Some medicines may change the amount of Xtandi in the body, while Xtandi may make other medicines work less effectively.1,2,4
Bring a complete list of all prescription medicines, over-the-counter products, vitamins, and supplements to ALL healthcare appointments. Include medicines used for blood pressure, cholesterol, diabetes, and blood thinning.
Ask your healthcare provider whether any medicines need to be changed, which symptoms need urgent medical attention, and how your health history, insurance coverage, transportation needs, and ability to attend follow-up visits may affect your care.
Tell your healthcare provider if you have:
Xtandi may raise blood pressure and increase the risk of heart problems. As high blood pressure affects 62.3% of non-Hispanic Black men, regular blood pressure checks and monitoring for side effects are especially important during prostate cancer treatment with Xtandi.⁸ Men who already have high blood pressure or heart disease may need closer follow-up and changes to their medicines, if problems develop.⁶˒⁷
Key Points
Patients with advanced prostate cancer may be able to access Xtandi through commercial insurance, Medicare Part D, or patient assistance programs for those who are uninsured or need financial support. XTANDI Support Solutions® access specialists can help patients understand their options, explore savings, and determine eligibility for discounted programs over the telephone. Learn more about access to Xtandi.
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking any drug or commencing or discontinuing any course of treatment.
Like the 62.3% of Black men with high blood pressure, you may need closer follow-up when taking Xtandi. Blood pressure could raise and you may increase the risk of heart problems while taking it. You should closely monitor and change medicines, if problems develop.
Xtandi can effect fertility as it may harm an unborn baby. Men with female partners who can become pregnant should use effective birth control during treatment and for three months after the last dose.
A study by George and other researchers included 2,910 veterans with advanced prostate cancer that had spread and kept growing despite very low testosterone. Among men treated with Xtandi or Zytiga, Black men lived about 33 months, compared with about 25 months for White men, after differences in age, health conditions, test results, and cancer spread were considered.⁶˒⁷
Enter your name and email to receive the download link.
