Enzalutimide given as first line treatment for Hormone sensitive PC.

My husband had his robotic prostectomy in February 2020 his PSA remained at 17 .The consultant said because of COVID and the fact a couple of lymph nodes were positive he could  prescribe Enzalutimide (Xandti) as the first line  hormone treatment and salvage RT after 6 months with a view to curing the PC .My husband started Xandti in June by July his PSA had dropped to 0.02 ,he has very bad hot flashes and brain fog and occasional headaches exacerbated by trying to give up coffee at the same time !!! .He also gets tired but all in all we are encouraged by the dramatic fall in PSA to relatively undetectable level.On reading up about responses to Enzalutimide it is apparent the faster and more dramatic the reduction in PSA the better the outcome.Its a very expensive drug which is why prior to COVID it was reserved for hormone  castrate resistant PC, it costs over £100 a day .Having had his prostate removed is apparently also a good thing because its taken the 'Mothership' away and any circulating cells are not re energised by the cancer in the prostate. So all in all quite positive however as we all know this cancer is unpredictable and we dont know how it will respond to RT .I was wondering if anyone else had been prescribed Xandti as a first line hormone treatment with a view to a cure .?

  • Hi 

    Although I don't have any experience with Enzalutimide to share with you I noticed that your post hadn't had any responses yet.

    While your waiting, if you type 'Enzalutimide' into the search bar at the top of this screen you'll find quite a few posts which mention it. You could have a read through those and reply to any of the more recent posters if you think they can help you further.

    When you have a minute, it would be really useful if you could pop something about your husband's journey so far into your profile as it really helps others when answering or looking for someone with a similar diagnosis. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.


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  • I have no experience of enzalutamide either - but I found this article quite interesting:
    Enzalutamide - Prostate Cancer UK

    - - -


    A healthy-looking decrepit, 69-year-old male, mentally alert but forgetful. I no longer have an urge to choke people who say "all you need to beat cancer is the right attitude" - better to smile and move on.

  • Hi

    I take Xandti or have for the last five days, mine is incurable this is the second line of defence, I know about hot flushes and the other effects just part and parcel of the treatment, you could ask for a drug that will help with the hot flushes it’s called Provera ask either the doctor or oncologist about it. 
    This and Aberaterone are both excellent drugs hopefully they will kill off the lymph nodes that are affected and all will be good.

    take care keep safe


  • Thanks for all your replies all information is very useful.From my investigations it looks like Enzalutimide can be exceptionally effective in some cases and they are only just now starting to give it as a treatment for failure after prostectomy .My husbands side affects are severe but manageable at this stage, he will have RT in the new year and hopefully this will kill off any remaining nasty cancer cells , in some cases where the lymph nodes have been affected Enzalutimide has effected a complete remission  when combined with RT with no evidence  of cancer remaining  .His consultant says they intend to cure him but as with all prostate cancer it may return .We have a phone consultation with a consultant on Tuesday and they will let us know more about the RT then.Its a roller coaster ride as you all know .His Gleason Score is 4 -3 and his PSA after prostectomy was 17 ot dropped to 0.02 after 5 weeks on Enzalutimide .

    1. Update , just had phone consultation with consultant .PSA now down to 0.01!!! after 4 months . She said the baseline psa taken just before starting Enzalutimide (Xandti) was 28.6 it had jumped from 17.1 in April to 28.6 in June quite a fast rise . She indicated that the RT should effect a good response due to the effect Enzalutimide has had .So anyone thinking about this drug as a first line hormone therapy  should consider it very carefully it is an expensive drug but is having great results for many men .The side effects can be troublesome but while it produces results like he has had they are bearable .