Evaluating the impact on quality of life of giving enzulatumide in combination with hormone therapy in patients with metastatic hormone-sensitive prostate cancer.

This study investigated the quality of life after treating patients with metastatic hormone-sensitive prostate cancer (mHSPC) with enzalutamide (Xtandi) in combination with hormone therapy. The study found that enzalutamide + hormone therapy improved the quality of life of patients, compared to hormone therapy alone.

Patients with mHSPC have prostate cancer that has spread beyond the prostate tumor. Generally, these patients are treated with hormone therapy such as androgen deprivation therapy (ADT). ADT reduces the production of androgens (male sex hormones such as testosterone). Reducing these androgens prevents cancer cell growth.

Enzalutamide is an androgen receptor blocker. It prevents the male hormones from reaching prostate cancer cells. Enzalutamide has shown improved survival in combination with ADT for the treatment of mHSPC. However, the impact of enzalutamide + ADT on the quality of life of patients is not yet known.

This study included 1150 patients with mHSPC . Patients were randomly assigned to receive either enzalutamide + ADT or ADT alone. The average follow-up time was 14.4 months. The quality of life-related to the patients' health was measured by patient questionnaires.

At the beginning of the study, both groups had similar quality of life scores. Patients treated with enzalutamide + ADT were 18% less likely to experience severe pain compared to ADT alone. The time it took for patients to experience severe pain was significantly longer with enzalutamide + ADT (14.09 months) compared to ADT alone (11.1 months). Patients treated with enzalutamide + ADT reported no worsening of their pain for 21% longer (19.38 months vs 16.76 months) compared to ADT alone.

This study showed that treating patients with enzalutamide + ADT delayed the time until worsening of their pain and quality of life compared to ADT alone.  

The study had a short follow-up time. We do not have information on the long-term impact enzalutamide + ADT could have on patient quality of life. Some patients started ADT therapy before the study began. The measurement of patient quality of life scores at the beginning of the study could have already been impacted by the ADT therapy. This study was funded by Astellas Pharma and Pfizer, the manufacturers of enzalutamide.