Xtandi vs Zytiga for mHSPCa

[6357axbz]

I was just reading about the success of Xtandi in the Phase III ARCHES trial when given along with ADT for extending radiographic PFS in mHSPCa. I’m trying to remember how this compares to Zytiga but am suffering from information overload at the moment. Does anyone know?

Randall

[Tall_Allen]

ARCHES only looked at radiographic progression-free survival so far. (Later, it will have survival results). The ENZAMET trial is being presented at the ASCO meeting today, I think. It has data on overall survival.

pcnrv.blogspot.com/2019/05/...

One of the STAMPEDE trials will directly compare enzalutamide and abiraterone. Until then, we won't have good comparative data.

[6357axbz in reply to Tall_Allen]

Nice summary, thanks TA. Yes, I saw the ARCHES trial needs many more deaths to occur in their study group for reliable stats on OS.

[pjoshea13]

This might be useful:

ncbi.nlm.nih.gov/pmc/articl...

-Patrick

[Hidden]

Here's an article on the subject.

ascopost.com/issues/august-...

[6357axbz in reply to Hidden]

Thanks Greg, it seems this article addresses HR (CR) PCa. Good info though.

[6357axbz]

Thanks all for your speedy input!!

[Hidden]

LATITUDE had a 33 month RPFS for Zytiga, but ARCHES has not reached the median RPFS for Xtandi. Median RPFS has been reached for the placebo group (19.45 months).

[Magnus1964]

I have had 3 1/2 years on zytiga and currently 3 years on xtandi, still moving forward.

Have you been on casodex yet? I got 5 years of that.

[6357axbz]

Nope, my mHSPCa dx was July 2018. Are you on Lupron as well? Do you have distant Mets? I do, ribs and iliac. Still HS. Are u?

[Fairwind]

Now that Zytiga is available as a generic at greatly reduced cost, insurance companies are certain to favor (insist) on its use over Xtandi...

I got 2 years out of Zytiga, then 4 months out of Xtandi. When they failed they failed quickly, PSA skyrocketing..

[JoelT in reply to Fairwind]

Both of these drugs can come with significant side effects. Xtandi with significant fatigue and Zytiga with major coronary concerns. These issues might give you an opportunity to argue for one drug over the other.

Joel

[Tjc1]

Besides the price favoring Zytiga, you have to take prednisolone with it. Also you are supposed to take it 2 hrs after or before a meal i think. Also, more blood test are required to keep check on yor liver funtion. Xtandi you dont.

[6357axbz]

2 hours after a meal and 1 hour before next meal

[EdBar]

Purely anecdotal here but I’ve been on Xtandi for about four and a half years now along with Lupron, Avodart and Metformin (Snuffy Myers protocol). PSA still undetectable and scans clear of active disease. Hoping for a long run.

Ed

[Hidden]

onclive.com/view/apalutamid...