In a nutshell
This study aimed to examine the effectiveness and safety of enzalutamide (Xtandi) in metastatic prostate cancer. This study found that enzalutamide was associated with longer progression-free and overall survival compared to standard of care.
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 treatments. Docetaxel (Taxotere) is a chemotherapy medication used in a number of cancers, including prostate cancer.
It is not known if adding enzalutamide to anti-hormone treatment, with or without early docetaxel, will improve survival in men with metastatic prostate cancer.
Methods & findings
This study included 1125 men. They were followed up for an average of 34 months. All patients had anti-hormone treatment. Group A had enzalutamide in addition. Group B had standard nonsteroidal antihormone therapy.
Overall survival rates at 3 years were 80% for group A. It was 72% for those in group B. Group A had a 33% higher odds of survival compared to group B. Survival without cancer growing or spreading was 60% higher in group A compared to group B.
Fatigue was more common in group A. Seizures occurred in 7 patients in the group A and in no patients in group B. Patients were more likely to stop treatment due to side effects if they were in group A.
The bottom line
This study found that enzalutamide was associated with significantly longer progression-free and overall survival compared to the standard of care in patients with advanced prostate cancer.
The fine print
This study was funded by Astellas, the manufacturer of enzalutamide.
Published By :
The New England Journal of Medicine
Jun 02, 2019
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