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Enzalutamide + AS vs AS Alone

User
Posted 14 Jul 2022 at 23:39

The results of a clinical trial carried out from July 2016 and August 2020 at 66 US and Canadian sites show that the use of Enzalutamide alongside AS vs AS alone has shown that the addition of Enzalutamide reduced the risk of pathological or therapeutic progression of prostate cancer by 46%.

In the UK to my knowledge Enzalutamide is only used in men diagnosed with advanced PCa and with the results of the ENACT clinical trial showing its favourable outcome in reducing progression in men with low risk or intermediate risk PCa, I hope the medical profession in the UK consider utilising Enzalutamide as a monotherapy in men on AS.

https://www.practiceupdate.com/C/137624/56?elsca1=emc_enews_topic-alert

Roger
User
Posted 15 Jul 2022 at 00:34

I don't find the results surprising, but given AS is for people who generally want to defer treatment to prolong QoL, I'm not sure many of those on AS would choose potentially live long hormone therapy as an option.

User
Posted 15 Jul 2022 at 18:51

I believe enzalutamide is very expensive. So this doesn't sound a very cost effective way of treating cancer. Was it sponsored by the makers of enzalutamide?

Dave

User
Posted 15 Jul 2022 at 19:05
Quote from the clinical trial publication:

Funding/Support: This study was funded by Astellas Pharma Inc and Pfizer Inc, the codevelopers of enzalutamide.

Commercial funding OMG!

Perhaps all research into disease and medical conditions should be the sole preserve of charitable funding and governments.

Roger
User
Posted 15 Jul 2022 at 21:44
My OH Gary has been on enzolutamine and Abi on the stampede trial for the last 6.5 years he’s had fantastic results as he’s PSA has been undetectable,after having early chemo as well .BUT his energy and sex drive has been nil .not sure if he’s being over treated,but do you try to decrease meds or carry on ? He’s only 62 and I’m 58 ,no one knows the answer so we carry on 😣

User
Posted 15 Jul 2022 at 21:55
Having enza surely means the patient isn't on AS?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Jul 2022 at 22:00
Being chemically castrated doesn't seem to offer many benefits...might as well have radical treatment??
User
Posted 19 Jul 2022 at 12:25

My onco has been trying to get me to start ht (enza) for over two months now, and so far I have said no. Because of the side effects. I just know I would not be happy after being chemically castrated.         Nick

Edited by member 19 Jul 2022 at 12:27  | Reason: Not specified

User
Posted 19 Jul 2022 at 18:04

What is AS please?       NICK

User
Posted 19 Jul 2022 at 18:13

Originally Posted by: Online Community Member

What is AS please?       NICK

Active surveillance is choosing not to have any treatment and being very closely monitored for any changes. It is really only suitable for men with a low risk, small tumour.  

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 Jul 2022 at 18:15

Originally Posted by: Online Community Member

My onco has been trying to get me to start ht (enza) for over two months now, and so far I have said no. Because of the side effects. I just know I would not be happy after being chemically castrated.         Nick

I have responded on your other post Nick 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Jul 2022 at 09:57
Just to say in reply to Dave, my OH has just be put on Enzalutimide (a week ago today) and when we went for the appointment to go through everything regarding taking it, it came out in conversation that one months supply was £3000 but the NHS negotiated a more favourable rate so weren’t paying that much. His previous treatments were chemo on diagnosis, stampede trial (using patches) which worked brilliantly for approx 2 years but he had to stop as became allergic to them; then put on 3 monthly stomach injections. His PSA started to rise a little so bicalutamide was added which halted the rise but that started to become ineffective and his numbers started rising quite quickly, that’s when the Enzalutimide was prescribed. Have yet to see the results of taking it as first blood test next week.

And to answer Nick’s post re side effects, all I can say is up to now hardly any. I say this with fingers crossed! When on bicalutamide he had awful hot sweats and slept quite a lot. The sweats seem to have subsided a little, but he still has several ‘chair’ naps during the day. He is being followed up every two weeks for eight weeks to check on possible side effects.

Merilyn

User
Posted 21 Jul 2022 at 16:45

Thanks for the info on enzalutamide. Zoladex is about £100 per month and bicalutamide £12 per month, so the idea that one would use enzalutamide before exhausting the cheap stuff is amazing.

Also people who are eligible for active surveillance will probably live ten or twenty years before anything needs doing, so that would be about half a million pounds in to the drug manufacturers pockets per patient. No wonder they sponsored the trial.

NICE will approve £20000/per year to keep a patient alive and in good health. I suspect the drug companies will be letting the NHS have it at this price. Now when you consider how much money the government wastes on overseas trips for MPs I don't think £20000 is too much for someone who has been paying his taxes to keep the ruling classes in a life of luxury.

 

Dave

 
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