Xgeva® (denosumab) (pron x-GEE-va) is the latest addition to the arsenal of treatment for skeletal-related events (SRE) in breast cancer patients with bone metastases from solid tumors (osteoclasts). It was approved for use in metastatic breast cancer (and a few other cancers) by the US Food and Drug Administration (FDA) in November 2010. Since then, we are hearing more about it as it is being added to our treatment regimens.
Here are a few facts.
- The two other SRE treatment drugs are Aredia® (pamidronate) and Zometa® (zoledronic acid).
- Xgeva was shown to be superior to Zometa in preventing SRE for a longer period, but it was not shown to have an advantage in extending either progression-free survival (PFS) or overall survival (OS).
- Xgeva does not affect the kidneys, which can be a problem for patients taking the other two drugs, Aredia or Zometa, for an extended time.
- Xgeva’s adverse effects include hypocalcemia and, rare, osteonecrosis of the jaw (ONJ); ONJ is also a rare complication of the other two drugs.
- Xgeva at $1650 is twice as expensive as the other drugs.
- Amgen offers a payment assistance plan, First Step, that does not have a requirement for financial need. Ask your oncology team whether they have the packets available for patients; otherwise, visit the site and call to register for the program.
- Denosumab has two names for its different applications: Xgeva for bone mets and Prolia® (a lower dose) for osteoporosis.
It may be likely that physicians will prescribe Xgeva for patients who, either, have renal function complications from or are intolerant of the bisphosphonate drugs, Aredia or Zometa.
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