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Zytiga vs Xtandi

Abiraterone  ·  Enzalutamide

The two leading oral therapies for advanced prostate cancer — one shuts down androgen production, the other blocks the receptor androgens act on.

At a glance

ZytigaAbiraterone
XtandiEnzalutamide
Brand name
Zytiga
Xtandi
Drug class
CYP17 inhibitor
Androgen receptor inhibitor
Route
Oral
Oral
Marketed by
Janssen (Johnson & Johnson)
Astellas
First FDA approval
28 Apr 2011
31 Aug 2012
US shortage
Not listed
Not listed

Key differences

What each one treats

ZytigaAbiraterone

ZYTIGA is indicated in combination with prednisone for the treatment of patients with Metastatic castration-resistant prostate cancer (CRPC) Metastatic high-risk castration-sensitive prostate cancer (CSPC) ZYTIGA is a CYP17 inhibitor indicated in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer (CRPC). ( 1 ) metastatic high-risk castration-sensitive prostate cancer (CSPC). ( 1 )

XtandiEnzalutamide

XTANDI ® is indicated for the treatment of patients with: • castration-resistant prostate cancer (CRPC) • metastatic castration-sensitive prostate cancer (mCSPC) • non‑metastatic castration‑sensitive prostate cancer (nmCSPC) with biochemical recurrence at high risk for metastasis (high-risk BCR) XTANDI is an androgen receptor inhibitor indicated for the treatment of patients with: • castration-resistant prostate cancer. ( 1 ) • metastatic castration-sensitive prostate cancer. ( 1 ) • non‑metastatic castration‑sensitive prostate cancer with biochemical recurrence at high risk for metastasis. ( 1 )

How each one works

ZytigaCYP17 inhibitor

12.1 Mechanism of Action Abiraterone acetate (ZYTIGA) is converted in vivo to abiraterone, an androgen biosynthesis inhibitor, that inhibits 17 α-hydroxylase/C17,20-lyase (CYP17). This enzyme is expressed in testicular, adrenal, and prostatic tumor tissues and is required for androgen biosynthesis. CYP17 catalyzes two sequential reactions: 1) the conversion of pregnenolone and progesterone to their 17α-hydroxy derivatives by 17α-hydroxylase activity and 2) the subsequent formation of dehydroepiandrosterone (DHEA) and androstenedione, respectively, by C17, 20 lyase activity. DHEA and androstenedione are androgens and are precursors of testosterone. Inhibition of CYP17 by abiraterone can also…

XtandiAndrogen receptor inhibitor

12.1 Mechanism of Action Enzalutamide is an androgen receptor inhibitor that acts on different steps in the androgen receptor signaling pathway. Enzalutamide has been shown to competitively inhibit androgen binding to androgen receptors; and consequently, inhibits nuclear translocation of androgen receptors and their interaction with DNA. A major metabolite, N‑desmethyl enzalutamide, exhibited similar in vitro activity to enzalutamide. Enzalutamide decreased proliferation and induced cell death of prostate cancer cells in vitro , and decreased tumor volume in a mouse prostate cancer xenograft model.

Read more

Zytiga profile Xtandi profile All comparisons
This is not medical advice, and not a recommendation of one drug over the other.

Which medicine is right for a given person depends on their diagnosis, other conditions, other medicines, kidney and liver function, pregnancy, and cost or reimbursement — none of which this page knows. Two drugs in the same class are not automatically interchangeable. Never start, stop or switch a prescription medicine on the basis of a web page; that decision belongs to you and your clinician or pharmacist.

Class and summary text is written by the Priya Life Science editorial team. Label, mechanism, route, manufacturer and approval data come from the U.S. FDA via the openFDA API; shortage status from the FDA Drug Shortage Database. Approvals, indications and brand names differ between the US, EU/Ireland (EMA/HPRA) and other regions — a drug approved in one may not be approved, or may carry a different name, in another.