New Clinical Trial Looks Promising as Prostate Cancer Treatment

Testosterone suppression plus either enzalutamide or standard nonsteroidal antiandrogen therapy showed an early overall survival benefit with enzalutamide in patients with metastatic hormone-sensitive prostate cancer (mHSPC). This finding was found in the interim analysis of the ENZAMET trial published in the journal The Lancet Oncology.

Survival of Men with Metastatic Hormone-sensitive Prostate Cancer

ENZAMET is a randomized trial undertaken to evaluate whether enzalutamide would improve survival outcomes in patients with mHSPC by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP). The study was planned about 10 years ago when the survival benefit of enzalutamide in metastatic castration-resistant prostate cancer was established but before docetaxel (anticancer drug) had been demonstrated to improve survival in mHSPC.

Enzalutamide is used to treat prostate cancer that has spread to other parts of the body and who have been helped by certain medical and surgical treatments that decrease testosterone levels. It works by blocking the effects of androgen (a male reproductive hormone) to stop the growth and spread of cancer cells.

The trial enrolled 1,125 patients and included a mix of prognostic groups. Patients were randomly assigned to enzalutamide or a standard nonsteroidal antiandrogen, each with standard testosterone suppression. Concurrent docetaxel was allowed at the investigator's discretion.

ENZAMET Confirms Benefit with Enzalutamide in Metastatic Hormone-Sensitive Prostate Cancer

For people with metastatic hormone-sensitive prostate cancer, the addition of an androgen receptor blocker with enzalutamide to standard therapy – suppression of testosterone, with or without chemotherapy - led to a 67 percent survival rate after five years. This compares to 57 percent of people who were alive after five years after receiving the standard best practice treatment.

The longer-term analysis showed that the benefit of adding enzalutamide was evident in all patient subgroups, regardless of when the cancer was found to have spread, how much was present, or whether people also received docetaxel chemotherapy.

These high-level findings indicate that the addition of enzalutamide should be considered as a treatment option for any patient able to receive it. The side effects of the addition of enzalutamide to the standard of care were overall like what has been experienced with enzalutamide in previous clinical trials.

ENZAMET was the first trial to show a survival benefit from the addition of enzalutamide, and the first to include patients receiving docetaxel chemotherapy at the same time. It has the flexibility to allow physicians and patients to decide whether combination therapy was an appropriate option.

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Source-Eurekalert