Evaluating enzalutamide plus androgen deprivation therapy to treat metastatic prostate cancer

This study aimed to examine the effectiveness and safety of enzalutamide (Xtandi) with androgen deprivation therapy (ADT) in metastatic prostate cancer. This study found that this combination was associated with longer progression-free and overall survival compared to ADT alone.

Patients with prostate cancer can be treated with various types of therapies. These included chemotherapy such as docetaxel (Taxotere). Another option in ADT. This is treatment that blocks male sex hormones that fuel the growth of prostate cancer. Enzalutamide is an anti-androgen medication. It blocks hormone receptors in the body (such as testosterone). It is used for patients with prostate cancer spread outside of the pelvis, who have not had chemotherapy and who have not responded to previous ADT. This is called metastatic castration-resistant prostate cancer. 

However, the effectiveness of enzalutamide in patients with metastatic hormone-sensitive prostate cancer treated with ADT is under investigation.

This study included 1150 men. They were randomly assigned to receive either 160 mg/daily of enzalutamide (group A) or a placebo (group B). All patients also had ADT. They were followed up for an average of 14.4 months.

Group A had a significantly lower risk of death or progression (by 61%) as compared to Group B. Significantly more patients in group A achieved undetectable prostate-specific antigen (PSA; a marker of prostate cancer) levels compared to those in group B.

Both groups had a good quality of life before and during the trial. Side-effects such as pain were reported by 24.3% of Group A as compared to 25.6% of Group B. 

This study found that enzalutamide plus ADT was associated with significantly longer progression-free and overall survival compared to ADT alone in patients with advanced prostate cancer.

This study was funded by Astellas, the manufacturer of enzalutamide.