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Zytiga

Active Substance: abiraterone acetate
Common Name: abiraterone
ATC Code: L02BX03
Marketing Authorisation Holder: Janssen-Cilag International N.V.
Active Substance: abiraterone acetate
Status: Authorised
Authorisation Date: 2011-09-05
Therapeutic Area: Prostatic Neoplasms
Pharmacotherapeutic Group: Endocrine therapy

Therapeutic Indication

ZYTIGA is indicated with prednisone or prednisolone for:
•         the treatment of metastatic castration resistant prostate cancer in adult men who are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy in whom chemotherapy is not yet clinically indicated (see section 5.1)
•         the treatment of metastatic castration resistant prostate cancer in adult men whose disease has progressed on or after a docetaxel based chemotherapy regimen.

What is Zytiga and what is it used for?

Zytiga is a medicine used to treat cancer of the prostate (a gland of the male reproductive system) in adult men when the cancer is metastatic (has spread to other parts of the body). It is used with the medicines prednisone or prednisolone when:
• medical castration (using medicines to stop the production of male hormones in the body) with a treatment called androgen deprivation therapy has not worked or no longer works in men who have either no symptoms or only mild symptoms of the disease, and who do not yet need chemotherapy (cancer medicines);
• medical or surgical castration and chemotherapy containing docetaxel have not worked or no longer work.
Zytiga contains the active substance abiraterone acetate.

How is Zytiga used?

Zytiga is available as tablets (250 and 500 mg) and can only be obtained with a prescription.
The recommended dose of Zytiga is 1,000 mg taken once a day at least two hours after eating and at least one hour before further food. If patients develop liver problems treatment should be stopped. Treatment may be resumed at a reduced dose if liver function returns to normal. For further information, see the summary of product characteristics.

How does Zytiga work?

The active substance in Zytiga, abiraterone acetate, is changed in the body to abiraterone which stops the body producing testosterone, a male hormone. Abiraterone does this by blocking an enzyme called CYP17 found in the testes and elsewhere in the body. Because the cancer needs a supply of testosterone to survive and grow, by reducing the production of testosterone, Zytiga may slow the growth of the prostate cancer.

What benefits of Zytiga have been shown in studies?

Zytiga was compared with placebo (a dummy treatment) in two main studies. In both studies, patients were also treated with prednisone or prednisolone.
The first study involved 1,195 men with metastatic prostate cancer whose disease had got worse despite surgical or medical castration treatment and chemotherapy with docetaxel. The main measure of effectiveness was overall survival (how long the patients lived). Patients treated with Zytiga lived for just under 15 months from the start of treatment compared with just under 11 months for patients given placebo.
The second study involved 1,088 men with metastatic prostate cancer who had either no symptoms or only mild symptoms of the disease and for whom castration treatment had not worked or had stopped working. The main measure of effectiveness was how long the patients lived without their disease getting worse. Patients treated with Zytiga lived for an average of around 16 months without their disease getting worse, compared with around 8 months in patients given placebo.

What are the risks associated with Zytiga?

The most common side effects with Zytiga (seen in more than 1 patient in 10) are urinary tract infection, hypokalaemia (low blood potassium levels), high blood pressure and peripheral oedema (swelling of the limbs due to fluid retention). Other important side effects include heart problems, liver problems, fractures and allergic alveolitis (a lung reaction causing cough and shortness of breath). For the full list of all side effects reported with Zytiga, see the package leaflet.
Zytiga must not be used in patients with severely reduced liver function. It is not for use in women and must not be given to women who are or who may be pregnant. For the full list of restrictions, see the package leaflet.

Why is Zytiga approved?

The Agency’s Committee for Medicinal Products for Human Use (CHMP) decided that Zytiga’s benefits are greater than its risks and recommended that it be approved for use in the EU. The CHMP noted that Zytiga in combination with prednisone or prednisolone improved survival compared with placebo in patients whose disease had got worse despite castration treatment and chemotherapy with docetaxel. The Committee noted that there were very few alternative treatments for those patients. The Committee also considered the fact that Zytiga is given by mouth to be a further advantage. In patients where medical castration has not worked and who have no or only mild symptoms, Zytiga is of benefit when chemotherapy is not yet required. Zytiga is well tolerated and its risks are considered manageable.

What measures are being taken to ensure the safe and effective use of Zytiga?

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Zytiga have been included in the summary of product characteristics and the package leaflet.

Other information about Zytiga

The European Commission granted a marketing authorisation valid throughout the European Union for Zytiga on 5 September 2011.

Source: European Medicines Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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