Should you use Denosumab (Xgeva) instead of Zoledronic Acid (Zometa) to delay skeletal-related events, reduce pain, and improve your quality of life?
Suppose you have castration-resistant prostate cancer (CRPC) with bone metastases (BM). In that case, you are at significant risk of suffering debilitating pain. This pain will impact every aspect of your daily functioning and significantly diminish your quality of life (QoL). There are options to treat this situation. Finding the best drug or treatment to control the pain will allow you to have a more complete and fulfilling life and increase your QoL.
The earlier standard of care for bone health in men in treatment for CRPC was a drug called Zoledronic Acid (Zometa). However, in Phase III clinical trials, the superiority of the drug called Denosumab (Xgeva) over Zoledronic acid (Zometa) has been demonstrated. Xgeva is superior in delaying or preventing the development of skeletal-related events, including pathological fractures.
An ad-hoc analysis, focusing on the subgroup of men with no or mild pain at baseline of this trial, showed that Xgeva is also superior to Zometa for pain interference (PI) and maintaining a better cancer-specific quality of life (QoL).
The trial showed that over 18 months, more Zometa treated men than Xgeva treated men experienced a more significant worsening of their QoL. In other words, men who used Xgeva had a better quality of life.
Denosumab, which also has shown its ability to delay the initial onset of skeletal-related events, again significantly slowed the time to worsening of pain and allowed men to maintain a better overall QoL
Should you be having Xgeva instead of Zoledronic acid? Speak to your doctor about this question.
Clinical trial information: NCT00321620.
J Clin Oncol 32, 2014 (suppl 4; abstr 12); Donald Patrick, Charles S. Cleeland, Lesley Fallowfield, Matthew Raymond Smith, Laurence Klotz, Stephane Oudard, Gavin M. Marx, Rachel Wei, Katarina Ohrling, Yi Qian
