There has been much hype regarding the new antiandrogen MDV 3100 (Enzalutamide) and its potential rivalry with Zytiga. Here is an analysis of the pros and cons of each agent to give a comparison of their utility in treating prostate cancer.
Zytiga (Abiraterone Acetate)
CYP17 Inhibitor. Designed specifically for prostate cancer targetted at the CYP17 enzyme responsible for testosterone biosynthesis.
Potential Utility: Last line hormonal therapy pre chemotherapy.
Advantages
Oral Drug. Good safety profile.
Licensed for the treatment of advanced prostate cancer post chemotherapy.
Used off label for pre chemotherapy patients.
Disadvantages
Prednisone for side effects.
Enzalutamide (MDV 3100)
Antiandrogen. Designed as an analogue of casodex (bicalutamide) and flutamide.
Potential Utility: Casodex relapsed patients. Combination with Zytiga for advanced prostate cancer.
Advantages
Oral Drug. Prednisone not required.
Disadvantages
Not currently licensed. Presently in Phase 3 clinical trials.
Possible cardiotoxic side effects (5 seizures reported in trials)
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