Xtandi is often referred to as a “super bicalutamide (Casodex).” Casodex functions as a androgen blockade, which deters testosterone from being able to interact with the prostate cancer cell and feed the growth of the cancer.

There are some oncologists in the United States and the standard hormone treatment in Europe often utilizes Casodex as mono-therapy thereby preserving a better quality of life in men with advanced prostate cancer which is still hormone responsive. However, the efficacy as a monotherapy with Casodex has been shown to be limited.

Xtandi, which like Casodex, is an oral androgen receptor (AR) inhibitor but with higher AR–binding affinity vs Bic, it prevents nuclear translocation, shows no DNA binding, and induces apoptosis of prostate cancer tumors. The FDA in the US approved Xtandi after prolonging overall survival in post-docetaxel metastatic castration resistant prostate cancer.

In a phase 2 study that assessed Xtandi as a monotherapy in men with hormone responsive and non-castrate testosterone (T) ?230 ng/dL Xtandi achieved a high PSA response rate and marked PSA decline with efficacy similar to cas