A new treatment developed by a doctor at Northwestern Medical Hospital offers hope for men suffering from prostate cancer. When hormonal therapies fail to abate the disease, enzalutamide, an oral medication, can offer an alternative.
In a three-year clinical trial, oncologist Dr. Maha Hussain found that enzalutamide resulted in a 71% lower risk of cancer spread or death compared to those taking the placebo. Men taking the drug also slowed cancer reappearance by almost two years.
Enzalutamide works by shutting down the receptor on the cancer cell that receives hormones like testosterone. Without these hormones, the cancer cell dies or goes dormant. The earlier this treatment is implemented, the more effective the drug, says Hussain.
The peer-reviewed study—sponsored by Pfizer and Astellas Pharma, who plan to manufacture enzalutamide under the brand name Xtandi—was published Thursday in the New England Journal of Medicine. Around 1,400 men between the ages of 50 and 95 participated in the study. In all participants, their prostate cancer hadn’t spread, but also hadn’t responded to hormone therapy.
The reach of prostate cancer is extensive: nearly 165,000 men were estimated to be diagnosed with prostate cancer just this year. In 2015, there were over 3 million men living with prostate cancer in the United States alone.
“I met prostate cancer at its most aggressive,” said Hussain in the Chicago Tribune, reflecting on her beginnings at the Detroit Veterans Affairs hospital in the 1980s, when there was little aid for those suffering from prostate cancer. “There was no way of diagnosing prostate cancer, or doing early detection. I ended up meeting patients coming through the emergency room with (spreading cancer), and nobody knew. They’d show up and they’d have back pain, or some paralysis, or trouble passing urine, blockage of their kidneys, and so on.”
Today, the disease is better understood, and older men are encouraged to get a prostate exam every four years.
“With the different options patients have in terms of treatment once they’re diagnosed, and the work that’s going on with regard to early detection, I think it’s caused significant shift,” said Hussain. “Cancer is being diagnosed, relatively speaking, at a much earlier stage, where it is potentially curable.”
Enzalutamide is currently approved for a certain subset of patients with prostate cancer—those whose cancer is spreading to other parts of the body and has not responded to hormone therapy. Expanded use of this drug is currently under review by the Federal Drug Administration.
Correction, July 1, 2018: An earlier version of this article misstated the FDA’s approval of enzalutamide.