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Xtandi® A New Standard Treatment for Men with Non-Metastatic Castration-Resistant Prostate Cancer?

CancerConnect News:  Results from the Phase 3 PROSPER clinical trial in patients with non-metastatic Castration-Resistant Prostate Cancer (CRPC) were released this week at the 2018 Genitourinary Cancers Symposium in San Francisco and demonstrate that the use of Xtandi® (enzalutamide) plus androgen deprivation therapy (ADT) significantly reduced the risk of developing metastases or death by 71 percent compared to ADT alone.

About Castration-Resistant Prostate Cancer

Prostate cancer is the second most common cancer in men worldwide.1 More than 164,000 men in the United States are estimated to be newly diagnosed with prostate cancer in 2018.2,3 Castration-resistant prostate cancer refers to the subset of men whose prostate cancer progresses despite castration levels of testosterone.4 Non-metastatic CRPC means there is no clinically detectable evidence of the cancer spreading to other parts of the body (metastases), and there is a rising prostate-specific antigen (PSA) level.5  Many men with non-metastatic CRPC and a rapidly rising PSA level go on to develop metastatic CRPC.  The relative 5-year survival rate for patients with distant stage prostate cancer is 30 percent and therapies that can delay the onset of metastasis in these patients is needed. 

About Xtandi


PROSPER is a comparative clinical trial that enrolled approximately 1,400 patients with non-metastatic CRPC that had progressed, based on a rising prostate-specific antigen (PSA) level despite ADT, but who had no symptoms and no prior or present evidence of metastatic disease. The trial directly compared Xtandi plus ADT to ADT alone.

The results of PROSPER demonstrated that Xtandi delayed the spread of cancer. Xtandi treated patients took 36.6 months for their disease to spread to other parts of the body compared to 14.7 months for men treated with ADT alone.  It is currently too soon to determine if Xtandi treated patients also have prolonged survival.

In patients with non-metastatic CRPC, there is a high unmet need to delay development of metastases and the progression to advanced prostate cancer. Treatment with Xtandi appears to address that need, giving men a treatment option where there previously has been none.


  1. American Cancer Society. Global Facts & Figures.….
  2. American Cancer Society. Cancer Facts & Figures 2018.….
  3. European Commission. Epidemiology of Prostate Cancer in Europe.
  4. Urology Care Foundation. Advanced Prostate Cancer Patient Guide.
  5. Luo J, Beer T, Graff J. Treatment of Non-metastatic Castration Resistant Prostate Cancer. Oncology. April 2016, 30(4):336-344.
  6. Smith MR, Kabbinavar F, Saad F, Hussain A et al. Natural history of rising serum prostate-specific antigen in men with castrate nonmetastatic prostate cancer. J Clin Oncol 2005; 23: 2918–2925.

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