There was a recent interview in the Pharma Strategy Blog with Dr. Bertrand Tombal , an academic urologist in Belgium. Dr. Tomal discussed several of the new advances in the treatment od advanced prostate cancer with an emphasis on the potential future of Enzalutamide (Xtandi).

Like bicalutamide (Casodex), Xtandi works by blocking (inhibiting) testosterone from interacting with the prostate cancer cell. However, it is more effective and has been described as a “super” bicalutamide (Casodex).

In Europe hormone therapy (ADT) differs from the standard in the United States. In the United Sates ADT uses drugs that are agonists, or that minimize the production of testosterone, sometimes along with bicalutamide and sometimes with bicalutamide for only a short period of time when first starting therapy.

Traditionally, in Europe the agonist drugs are not used, but instead the ADT is the use of solely bicalutamide at a higher dose. This method is attractive, as it seems to have a lower side effect profile.

Xtandi, or the “super “ inhibitor has been approved for use in the United