Treatment Name: Enzalutamide (Xtandi®)
Enzalutamide (Xtandi®) is a Chemotherapy Regimen for Prostate Cancer
How does Enzalutamide work?
Enzalutamide slows the growth of prostate cancer cells and decreases the size of prostate tumors. In prostate cancer, androgens (steroids made naturally by your body in the testes, adrenal glands, and prostate tumors) bind to androgen receptors and cause the cancer cells to grow. Enzalutamide is known as an anti-androgen and it works by blocking androgen receptors so that androgens, such as testosterone, cannot bind to the receptor which prevents it from stimulating the cancer.
Goals of therapy:
Enzalutamide is medication taken by mouth to slow tumor growth and alleviate symptoms. Enzalutamide has been shown to increase survival and improve quality of life, but is not usually given with the goal of cure.
- Usual starting dose: 160 mg (four 40 mg oral capsules) by mouth once daily
- All four capsules should be taken at the same time and swallowed whole
Enzalutamide is usually taken at home.
Typical duration of therapy is until the medication no longer works or if the patient cannot tolerate the medication. If you cannot tolerate the medications, talk to your doctor.
In clinical studies the most commonly reported side effects with enzalutamide are shown here. Side effects sometimes have percentage ranges [example: fatigue occurred 16 - 21%] because they differed between clinical studies:
Percentage of patients that discontinued due to unacceptable side effects: 6 - 8%.
How often is monitoring needed?
Your doctor may monitor your blood electrolytes using a Comprehensive Metabolic Panel (CMP) if having diarrhea while taking enzalutamide. If you are taking warfarin (Coumadin®) your doctor may check your INR more frequently.
How often is imaging needed?
A PET or CT scan may be required before treatment, or at intervals determined by your doctor.
How might blood test results/imaging affect treatment?
Depending upon the results your doctor may advise to continue this treatment as planned, or delay, or switch therapy
- Patients should be cautious about falling and injuries related to falling. Falls can be caused by fatigue and blood pressure changes caused by this drug
- Rare instances of seizure have occurred in patients taking enzalutamide. Patients should be made aware of the risk of engaging in activities that may lead to serious injury if a seizure should occur. According to the manufacturer, patients who have a seizure while on enzalutamide should be taken off the medication
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for prostate cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Enzalutamide (Xtandi®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Enzalutamide (Xtandi®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Enzalutamide (Xtandi®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Enzalutamide (Xtandi®)