Astellas 'Xtandi' offers high efficacy with low side effects

Dr. Hong Koo Ha, Professor in the Department of Urology at Pusan National University Hospital

Benefits observed in patients prescribed Extandi align with those in the ARCHES Phase 3 study

Emphasizes the role of regional hospitals in treating prostate cancer, prevalent in older age

As more treatment options are covered by reimbursement, concerns about 'how' best to treat prostate cancer are increasing.

 

Given the increasing number of prostate cancer patients increases each year, it is important to discuss which options to provide based on the patient's condition.

 

Dr.

 

Hong Koo Ha, Professor in the Department of Urology at Pusan National University Hospital

The specialist in the field, Dr.

 

Hong Koo Ha, Professor in the Department of Urology at Pusan National University Hospital, emphasizes that there must be discussions about patient-customized treatment.

 

The incidence of prostate cancer is rising among men diagnosed with cancer.

 

The increase in diagnosis is attributed to factors such as aging, westernized dietary habits, and more frequent PSA (Prostate Specific Antigen) testing.

 

"PSA testing was available in the past.

 

However, prostate cancer surgery has increased 5-6-fold," Dr.

 

Ha said.

 

"Increased access to PSA testing due to heightened interest in changed dietary habits and disease has contributed to the increased incidence." Dr.

 

Ha explained.

 

What's different from the past is the variety of available treatment options.

 

Dr.

 

Ha analyzes that prostate cancer treatment options are extensive as new therapies continue to be introduced.

 

"Most patients, when initially diagnosed, fall into the early-stage hormone-responsive prostate cancer where patients respond to hormone therapy.

 

During diagnosis, metastasis affects the later treatment direction.

 

The size of cancer also contributes significantly to prognosis and treatment response.

 

The treatment course differs depending on the patient's condition, even in the mid-stage," Dr.

 

Ha said.

 

Hormone therapies play significant role…Extandi with extended reimbursement, 'positive sign' At the early stage of prostate cancer, surgery is recommended.

 

When cancer progresses, combinations of surgery, radioactive therapy, and hormone therapy are used.

 

And treatment outcomes have been reported to be similar to those received at the early stage.

 

The issue arises when there is metastasis.

 

According to Dr.

 

Ha, a patient's survival period depends on the treatment selection in this case.

 

Currently, when there is metastasis, the most common option is hormone therapy.

 

Hormone therapy advanced after the first generation, and now three types of next-generation hormone therapy have been demonstrated to provide extended survival periods.

 

One of the latest updates is approval of essential reimbursement to the use of Astellas Pharma's Xtandi (enzalutamide) in combination with an androgen deprivation therapy (ADT) for the treatment of hormone-responsive metastatic prostate cancer (HSPC).

 

An expanded role of Extandi has been projected, as the drug can be used regardless of the presence of metastasis (whether in hormone-responsive prostate cancer or following biochemical relapse).

 

Now that a year has passed since the expanded reimbursement, what would be Dr.

 

Ha's opinion be on this?

 

Dr.

 

Ha focused on the effectiveness of Extandi and the low likelihood of side effects.

 

"When outpatient patients with HSPC were treated with Extandi, the results were comparable to those of the ARCHES Phase 3 study, which demonstrated that Extandi significantly reduces disease progression and the death risk, were shown," Dr.

 

Ha said.

 

"As for side effects, Extandi is relatively free of side effects.

 

Therefore, doctors prescribe this drug based on its proven safety and effectiveness." Previously, in the ARCHES Phase 3 study, a 'combination therapy of Extandi+ADT" has been shown to reduce radiographic Progression-Free Survival (rPFS) by 61%.

 

"Extandi can be widely used in almost all patients with prostate cancer regardless of the presence of metastasis, and it is relatively free of side effects than other medications that are similar in administration methods and molecular formulation," Dr.

 

Ha remarked.

 

"As doctors, we are less burdened to explain side effects within the tight time of outpatient consultation." "Regional hospitals pay a crucial role in the treatment of prostate cancer, which requires continuous treatment" Also, Dr.

 

Ha mentioned the role of regional medical centers where patients can continue to receive treatments for prostate cancer, which is diagnosed with increased age and patients have accompanying diseases.

 

"Considering the nature of prostate cancer, we must discuss issues that arise during the continued treatment course.

 

Continuance of treatment at initially diagnosed hospitals has the benefit of quick response when an unexpected issue arises and provides safe care for patients.

 

Regional medical centers play an important role regarding this matter," Dr.

 

Ha said.

 

Dr.

 

Ha recommends patient-customized therapy for the treatment of prostate cancer.

 

Dr.

 

Ha has been conducting collaborative research to develop methods for analyzing patient characteristics and diagnosing using Artificial Intelligence (AI).

 

"Compared to data on prostate cancer surgery from 6-7 years ago, prostate cancer in South Korea had higher malignancy and stages than those in the United States.

 

We are reviewing the proteomics data," Dr.

 

Ha said.

 

"Also, we are collaborating with a Korea-based AI company to use the latest trend AI for research on prostate cancer diagnosis." Additionally, Dr.

 

Ha emphasizes that expanding reimbursement of prostate cancer treatment options and enabling government-funded PSA tests is essential.

 

"Most prostate cancer treatments are costly.

 

If government-funded insurance reimbursement is not applied, it is difficult for doctors to prescribe this medication to patients.

 

We hope that a quick reimbursement process will provide practical and benefits for patients when new prostate cancer is introduced," Dr.

 

Ha remarked.

 

Dr.

 

Ha added, "Cost-effectiveness is important for testing and screening.

 

PSA test costs KRW 10,000 per session and can be done once every 1-2 years, which is relatively inexpensive." He added, "Conducting PSA tests more widely for early diagnosis of prostate cancer, early diagnosis of prostate cancer, can lead to efficient patient treatment and lower costs in the long run, which is projected to become the top cancer among men."