This is a summary of the European public assessment report (EPAR) for Xtandi. It explains how the Agency assessed the medicine to recommend its authorisation in the European Union (EU) and its conditions of use. It is not intended to provide practical advice on how to use Xtandi.
For practical information about using Xtandi, patients should read the package leaflet or contact their doctor or pharmacist.
- What is Xtandi and what is it used for?
Xtandi is an anticancer medicine that contains the active substance enzalutamide. It is used to treat adult men with cancer of the prostate (a gland of the male reproductive system). Xtandi is used when the cancer is metastatic (has spread to other parts of the body), and when medical or surgical castration (stopping the production of male hormones in the body using medicines or surgery) and treatment with docetaxel (another anticancer medicine) have not worked or no longer work.
- How is Xtandi used?
Xtandi is available as capsules (40 mg) and can only be obtained with a prescription. The recommended dose is 160 mg (four capsules) once a day with water. Treatment may have to be interrupted or the dose reduced if patients experience certain side effects. Xtandi should not be used together with certain medicines known as ‘strong CYP2C8 inhibitors’ that affect the way that Xtandi is eliminated by the body, or the dose of Xtandi should be reduced. For further information, see the package leaflet.
- How does Xtandi work?
The active substance in Xtandi, enzalutamide, works by blocking the action of the male hormone testosterone and other male hormones known as androgens. Enzalutamide does this by blocking the receptors on the surface of cells to which these hormones attach and preventing them from responding. Because prostate cancer needs testosterone and other male hormones to survive and grow, by blocking these hormones, enzalutamide slows down the growth of the prostate cancer.
- What benefits of Xtandi have been shown in studies?
Xtandi was compared with placebo (a dummy treatment) in one main study involving 1,199 patients with castration-resistant prostate cancer who were previously treated with docetaxel. The main measure of effectiveness was overall survival (how long the patients lived). The study showed that Xtandi was more effective than placebo at prolonging patients’ lives: on average, patients treated with Xtandi lived for 18.4 months, compared with 13.6 months for patients given placebo.
- What are the risks associated with Xtandi?
The most common side effects with Xtandi (which may affect more than 1 in 10 people) are headache and hot flushes. Seizures (fits) occurred in 8 patients in 1,000. For the full list of all side effects reported with Xtandi, see the package leaflet.
Xtandi is not for use in women and must not be given to women who are or who may be pregnant. For the full list of restrictions, see the package leaflet.
- Why is Xtandi approved?
The Agency’s Committee for Medicinal Products for Human Use (CHMP) decided that Xtandi’s benefits are greater than its risks and recommended that it be approved for use in the EU. The CHMP considered that the anticancer effects of Xtandi had been clearly demonstrated and that its benefit in terms of prolonging life is important for patients. Regarding its safety, the Committee concluded that the side effects with Xtandi were generally mild and could be managed appropriately.
- What measures are being taken to ensure the safe and effective use of Xtandi?
A risk-management plan has been developed to ensure that Xtandi is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Xtandi, including the appropriate precautions to be followed by healthcare professionals and patients.
In addition, the company will perform a safety study to further assess the risks with Xtandi for patients who are at a higher risk of seizures.
- Other information about Xtandi
The European Commission granted a marketing authorisation valid throughout the European Union for Xtandi on 21 June 2013.
For more information about treatment with Xtandi, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.
This EPAR was last updated on 02/07/2013 .
21/06/2013 Xtandi -EMEA/H/C/002639 --
- Annex I - Summary of product characteristics
- Annex IIA - Manufacturing-authorisation holder responsible for batch release
- Annex IIB - Conditions of the marketing authorisation
- Annex IIIA - Labelling
- Annex IIIB - Package leaflet
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Not yet assigned
Treatment of adult men with metastatic castration‑resistant prostate cancer whose disease has progressed on or after docetaxel therapy.
Changes since initial authorisation of medicine
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Initial marketing-authorisation documents
This medicine is approved for use in the European Union