Xofigo Compared to Provenge

Comparing Xofigo to Provenge is a factor that men with prostate cancer may have to consider. The Food and Drug Administration (FDA) approved a new medication, Xofigo (radium-223 dichloride), for late stage castration-resistant prostate cancer on May 15, 2013.

With this new addition of medication on the market, prostate cancer patients will want to ask how it compares to other available medications they are taking or considering. Provenge (sipuleucel-T) is an immunotherapy that was approved by the FDA April 29, 2010, for men with advanced stage prostate cancer.

How do Xofigo and Provenge work?

Both medications are used for prostate cancers that have metastasized, or spread to other areas of the body.

Xofigo in an injectable medication that has an anti-tumor effect. The medication contains radium (a heavy metal), which delivers radiation directly to bone tumors without significantly damaging surrounding tissues. This breaks up double-strand DNA, killing the prostate cancer cell at the site of cancer-induced increased bone turnover. Therapy consists of six injections given at four-week intervals.

Provenge uses immunotherapy, the body’s own immune system, to fight the cancer. Immunotherapy does not destroy or harm prostate cells in the body, whether they are cancer cells or healthy cells. This kind of therapy is considered a positive therapy. Treatment with Provenge usually takes three doses over five weeks. Each dose involves collecting a patient’s blood, harvesting certain cells, modifying those cells, and then returning the remaining blood to the patient a few days later via an infusion. Patients like that they are using their body’s own cells to help them fight prostate cancer.

How do Xofigo and Provenge extend life?

In clinical trials, men who took Provenge lived an average of 25.8 months compared with men who took a placebo, who lived on average 21.7 months. On average, Provenge extended life 4.1 months longer than the placebo.

Men on Xofigo survived a median of 14 months compared with men taking a placebo, who lived a little over 11 months. Xofigo extended life 3 months longer than the placebo.

Xofigo compared to Provenge: who is eligible?

Both drugs are used for advanced stages of prostate cancer that have spread despite hormone therapy. Xofigo is only for cancers that have spread to the bones and not other organs. It cannot be used with chemotherapy.

Provenge can be used for cancers that have spread to the bones and other parts of the body as well. Patients who are candidates for Provenge have minimal symptoms and have no pain or pain that does not require narcotic medication. Because Provenge is an immunotherapy, it can be used before other treatments such as chemotherapy.

Xofigo compared to Provenge: side effects

Both medications have mild common side effects.

Most common side effects of Xofigo include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Swelling of the leg, ankle, or foot

These Xofigo side effects are from the clinical trials, so it is assumed that as the drug is used in practice, more side effects may become known.

Common side effects of Provenge include:

  • Muscle aches and pains
  • Joint pain
  • Fatigue
  • Fever
  • Chills
  • Headache
  • Nausea

Contact your doctor right away if you experience breathing problems, chest pains, racing heart or irregular heartbeats, dizziness, nausea, or vomiting after getting Provenge because any of these may be signs of heart or lung problems.

 Xofigo compared to Provenge: cost

Xofigo costs $69,000 for the complete course of therapy. Because it is new, patients need to check with their insurance carrier for coverage. Bayer will have a patient assistant program to help with costs.

Provenge costs over $90,000, but is usually covered by most insurance plans and Medicare. The drug’s manufacturer, Dendreon, offers financial assistance. Provenge may be provided free for patients without insurance or who demonstrate a financial need. For patients who qualify, Dendreon may reimburse or offer financial assistance for copays, co-insurance, or deductibles.

Xofigo compared to Provenge: which one for you?

Your physician can help you determine which medication is right for you based on your symptoms, metastases, and other treatments you are using. If your prostate cancer has spread beyond bones to other organs, then Xofigo is not the right treatment for you. Provenge has the advantage that it can be used in conjunction with other therapies. Ultimately, you and your loved ones will have to weigh the costs and benefits of treatment choices to make a decision that is right for you.

Read more in our Prostate Cancer Health Center.