Hormonal Therapy for Prostate Cancer: A Closer Look

While hormone therapies are effective in many men who have prostate cancer, not all such patients benefit from these treatments. For some, they may not work at all. For others, they may only work for a while and then stop working. Fortunately, there are more options than ever before available to help men who have castration-resistant prostate cancer, an advanced form of prostate cancer that has gotten worse after hormone therapy or surgery:

Zytiga (abiraterone acetate) and Xtandi (enzalutamide) share some similarities. Zytiga blocks the production of androgens, and Xtandi works a bit differently to block the androgen receptor.

Zytiga, which is given in combination with prednisone, was originally approved as a treatment for men whose prostate cancer had gotten worse after treatment with Taxotere (docetaxel) chemotherapy, but is now more often used in patients with metastatic castration-resistant prostate cancer prior to receiving chemotherapy. Similar to Zytiga’s most recent indication, Xtandi is approved to treat men with metastatic castration-resistant prostate cancer that has not been treated with chemotherapy but has spread or recurred after hormone therapy or surgery.

Experimental agents include apalutamide, a drug similar to enzalutamide but with less central nervous system penetration, which could potentially result in reduced levels of fatigue and risk of seizures, and ODM-201, meant for patients who do not have metastatic disease.