Magazine article Drug Topics

New Prostate Cancer Drug Cuts Pain, Improves Survival

Magazine article Drug Topics

New Prostate Cancer Drug Cuts Pain, Improves Survival

Article excerpt

Free drugs! Before you get too excited, here's the full story: It's one month's supply of a newly approved antiandrogen drug for metastatic prostate cancer. A physician can give patients their first month's supply of nilutamide (Nilandron) free, thanks to manufacturer Hoechst Marion Roussel, which expects to market the drug in early November.

Nilutamide decreases bone pain and improves survival-at least compared to placebo-according to a study that found:

Bone pain improvement among 54% of nilutamide patients versus 37% of placebo patients

Nilutamide patients' progression-free survival extending to 21.1 months, compared with placebo patients' 14.9 months

Median overall survival lasting 273 months versus 23.6 months for placebo patients

Currently, there are two other antiandrogen drugs, Casodex (bicalutamide, Zeneca) and Eulexin (flutamide, Schering), on the market. When nilutamide is compared to those drugs, "toxicity profiles vary, but nilutamide has similar efficacy," said Joseph Oesterling, M.D., professor and chairman of the urology department at the University of Michigan medical school in Ann Arbor. Oesterling emphasized that none of the drugs should be used as monotherapy. All three drugs can cause androgen withdrawal syndrome, so it's good to have another alternative to switch to in order to take care of the problem, he told Drug Topics in a telephone interview.

While nilutamide has the same convenient oral, once-daily dosing as bicalutamide, said Oesterling, he expects the new drug to be priced lower than the other antiandrogens. The average wholesale price is $233.58 per box ($7.79 a day), a spokesman for Hoechst Marion Roussel said. Nilutamide has approval only for use with bilateral orchiectomy, but Oesterling predicted the drug would be equally effective with an LH-RH agonist, and he suspects many physicians will use nilutamide with this chemical castration method.

Is the drug worth the price for an additional four months' survival? "Maybe not to you or me," Oesterling said, "but those months can be important to a 78-year-old man who wants to see his first grandchild or experience one more holiday."

Each of the antiandrogen drugs has its own unique side effect profile. …

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