Prostate and breast cancer patients in Quebec now have access to XGEVA, a first-in-class treatment that reduces the risk of bone complications
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MISSISSAUGA, ON, Feb. 1, 2012 /CNW/ - As of today, many men with prostate cancer and women with breast cancer covered by the Quebec provincial drug plan will have access to XGEVA® (denosumab), a unique treatment for reducing the risk of bone complications, or skeletal-related events (SREs), such as fracture, radiation to bone, spinal cord compression or surgery to bone in patients with these cancers.
Based on the results of three pivotal, Phase 3 head-to-head trials, XGEVA demonstrated a clinically meaningful improvement by demonstrating superiority in reducing the risk of developing SREs compared to Zometa in patients with breast or prostate cancer and bone metastases. In addition, unlike most bone-targeted therapies on the market today which must be administered via intravenous infusion, XGEVA is delivered as an injection under the skin, 120 mg once every four weeks. XGEVA is not cleared by the kidneys; therefore, dose adjustment for renal impairment is not required.
"Amgen Canada is very pleased that the Conseil du medicament has recognized the value of XGEVA for prostate and breast cancer patients," said Dr. Clive Ward-Able, Executive Director, Research and Development, Amgen Canada Inc. "As the first province to list XGEVA on its formulary, Quebec has demonstrated leadership by making a new treatment option available to help these patients avoid potentially debilitating and costly bone complications arising from their cancers."
Amgen Canada continues to work with officials in each of the other provinces to provide access to XGEVA through provincial drug plans for cancer patients.
XGEVA is listed as a médicament d'exception for the prevention of SREs for men with castrate-resistant prostate cancer presenting with at least one bone metastasis; and for the prevention of SREs for people with breast cancer presenting with at least one bone metastasis, when there is intolerance to pamidronate.
"For patients with advanced breast or prostate cancer, one of the most common areas for cancer to spread is to the bone. When this happens patients can experience debilitating bone complications," said Dr. Fred Saad, urologist with the Centre Hospitalier de l'Université de Montréal. "In Quebec many patients affected by these complications will now have access to a novel treatment that can help protect their bones."
Bone metastases, the spread of cancer from its site of origin to the bones, are a serious concern for patients with advanced cancer. Up to 90 per cent of men with advanced prostate cancer develop bone metastases throughout the course of their disease.1,2,3 In addition, sixty-five to seventy-five per cent of people with advanced breast cancer can eventually develop bone metastases throughout the course of their disease.4 Many of these patients do not receive bone-targeted therapy. Bones weakened by metastases can lead to fractures and compression of the spinal cord and necessitate procedures like major surgery and radiation. The primary goal for using bone-targeted therapies is to reduce the risk of these debilitating and costly bone complications, which can disrupt a patient's life and cause disability, pain and hospitalization.
Patients who experience an SRE as a result of bone metastases incur significantly higher medical costs compared with those who do not experience such events.5,6 In addition, once patients experience an SRE, the risk of a subsequent SRE is increased.7 The costs of SREs vary by type and severity, ranging from relatively low costs for minor fractures to high cost events like spinal cord compression associated with hospitalization. Studies have shown that the costs of treating SREs are a significant cost burden. The total economic burden of patients with bone metastases in the U.S. alone is estimated to be $12.6 billion annually.8
Important Safety Information
XGEVA is not indicated for reducing the risk of developing SREs in patients with multiple myeloma.9
XGEVA can cause severe hypocalcemia. Correct pre-existing hypocalcemia prior to XGEVA treatment. Monitor calcium levels and administer calcium, magnesium, and vitamin D as necessary. Advise patients to contact a healthcare professional for symptoms of hypocalcemia.9
Osteonecrosis of the jaw (ONJ) can occur in patients receiving XGEVA. Patients who are suspected of having or who develop ONJ while on XGEVA should receive care by a dentist or an oral surgeon. In these patients, extensive dental surgery to treat ONJ may exacerbate the condition.9
The most common adverse events observed in clinical trials of patients receiving XGEVA versus zoledronic acid were fatigue (27.1 per cent vs 27.0 per cent respectively) and asthenia (21.4 per cent vs 21.9 per cent respectively); hypophosphatemia (32.1 per cent vs 19.6 per cent respectively); and nausea (30.8 per cent vs 31.6 per cent respectively). The most common adverse reactions resulting in discontinuation of XGEVA were osteonecrosis of the jaw and hypocalcemia.9 Please visit www.amgen.ca for the full product monograph.
Denosumab is also marketed as Prolia® for other indications. Patients being treated with XGEVA should not receive Prolia.
About XGEVA® (denosumab)
XGEVA (denosumab) is indicated for reducing the risk of developing skeletal-related events in patients with bone metastases from breast cancer, prostate cancer, non-small cell lung cancer, and other solid tumours.9 XGEVA is not indicated for reducing the risk of developing skeletal-related events in patients with multiple myeloma.9
Prolia® is the trade name for denosumab in postmenopausal osteoporosis for which it is administered once every six months subcutaneously as a 60 mg single dose pre-filled syringe.
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XGEVA® is a registered trademark of Amgen Inc., used with permission.
1 Tannock IF, de Wit, R, Berry WR, et al. Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer. N Engl J Med 2004;351:1502-12
2 Scher HI, Morris MJ, Kelly MK. Prostate Cancer Clinical Trial End points: "RECIST"ing a Step Backwards. Clin Cancer Res 2005:11:5223-5232. Published online July 20, 2005.
3 Petrylak DP, Tangen CM, Hussain MHA, et al. Docetaxel and Estramustine Compared with Mitoxantrone and Prednisone for Advanced Refractory Prostate Cancer. N Engl J Med 2004;351:1513-20.
4 Coleman RE. Skeletal complications of malignancy. Cancer. 1997:80 (suppl): 1588-1594
5 Delea T, Langer C, McKiernan J, et al. The cost of treatment of skeletal-related events in patients with bone metastases from lung cancer. Oncology 2004;67:390-396.
6 Schulman KL, Kohles J. Economic burden of metastic bone disease in the U.S. American Cancer Society 2007:2334-2342.
7 Saad F, gleason DM, Murray R, Tchekmedyian S, Venner P, Lacombe L, et al. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer. J Natl Cancer Instit 2004;96(11):879-882.
8 Schulman KL, Kohles J. Economic burden of metastatic bone disease in the U.S. American Cancer Society 2007:2334-2342.
9 XGEVA® Product Monograph. Amgen Canada Inc. October 14, 2011
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