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Survey: Oncologists More Willing Than Urologists to Prescribe Xtandi (Enzalutamide) for Prostate Cancer

Drug considered generally equivalent to abiraterone (Nov. 29)

BioTrends Research Group, a research and advisory firm located in Exton, Pa., finds that at 1 month after launch, less than 10% of surveyed urologists — but more than a third of oncologists — say they have used Xtandi (enzalutamide, Astellas Pharma US) in clinical practice for the treatment of prostate cancer. The lack of familiarity with Xtandi was the greatest factor currently holding urologists back from prescribing Xtandi. Of current nonprescribers, the majority of oncologists said that they will prescribe Xtandi within the next 3 months or sooner. Although urologists said that they will take longer before they prescribe Xtandi, the majority indicated that they will prescribe drug within the next 6 months or sooner.

“The launch of Xtandi is a major threat to Zytiga’s continued growth in post-docetaxel metastatic castrate-resistant prostate cancer (MCRPC),” said Andrew Merron, PhD. “Urologists and oncologists frequently cite Zytiga and Sanofi’s Jevtana as being the currently available therapies which Xtandi is most likely to displace. Approximately one half of surveyed physicians have a more favorable opinion of Xtandi versus Zytiga, compared to less than 15% who have a more favorable opinion of Zytiga versus Xtandi. Nevertheless, a large proportion of respondents consider these agents equivalent.”

In the survey, physicians generally believed that Xtandi and Zytiga (abiraterone, Janssen Biotech) have comparable overall toxicities. Seizure was most commonly perceived to be a greater concern with Xtandi compared with other agents used to treat docetaxel-pretreated MCRPC. Should both drugs gain approval for the treatment of asymptomatic or minimally symptomatic MCRPC, most respondents said that they will prescribe Xtandi in place of Zytiga.

Forty-nine U.S. oncologists and 49 urologists participated in the survey in October 2012.

Source: BioTrends Research Group; November 29, 2012.

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