PBS today: Xtandi or Zytiga after chemo: pick one only. Neither drug before chemo.

[Admin]

Jim Marshall (not a doctor) said ...

Today Xtandi (enzalutamide) was added to the PBS, and the rules for Zytiga (abiraterone) were changed.

 

Both of these are available on the PBS after chemotherapy with Taxotere (docetaxel). Neither is available before chemo at this time.

 

As you can see below, the entries are virtually identical.

 

Also you can see that if a man chooses to have one of these drugs subsidised by the PBS, the PBS will not later subsidise the other.

 

Each drug may be available if a man is intolerant to the other. (A severe reaction to the other drug, not just if the other drug does not work.) 

 

Each drugs may be available if your doctor predicts docetaxel intolerance.

... end Jim

 

Xtandi (Enzalutamide)

Castration resistant metastatic carcinoma of the prostate

Clinical criteria:

The treatment must not be used in combination with chemotherapy,

AND

Patient must have failed treatment with docetaxel due to resistance or intolerance; OR

Patient must be unsuitable for docetaxel treatment on the basis of predicted intolerance to docetaxel,

AND

Patient must have a WHO performance status of 2 or less,

AND

Patient must not receive PBS-subsidised treatment with this drug if progressive disease develops while on this drug,

AND

Patient must not have received prior treatment with abiraterone; OR

Patient must have developed intolerance to abiraterone of a severity necessitating permanent treatment withdrawal.

 

Zytiga (Abiraterone)

Castration resistant metastatic carcinoma of the prostate

Clinical criteria:

The treatment must be in combination with prednisone or prednisolone,

AND

The treatment must not be used in combination with chemotherapy,

AND

Patient must have failed treatment with docetaxel due to resistance or intolerance; OR

Patient must be unsuitable for docetaxel treatment on the basis of predicted intolerance to docetaxel,

AND

Patient must have a WHO performance status of 2 or less,

AND

Patient must not receive PBS-subsidised abiraterone if progressive disease develops while on abiraterone,

AND

Patient must not have received prior treatment with enzalutamide; OR

Patient must have developed intolerance to enzalutamide of a severity necessitating permanent treatment withdrawal.