Enzalutamide Improves Survival in Patients with Advanced Prostate Cancer

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An independent data safety and monitoring committee recommended stopping the PREVAIL trial early and allowing the men assigned to the placebo group to begin taking enzalutamide. In the trial, 1,717 men with metastatic castrate-resistant prostate cancer who were chemotherapy-naïve were randomly assigned to receive 160 mg of enzalutamide or a placebo taken orally once daily. Primary end points were overall survival and radiographic progression-free survival. Secondary end points were time to initiation of chemotherapy and time to the first skeletal-related event. The rate of radiographic progression-free survival was 65% vs 14% among men taking enzalutamide and placebo, respectively, at 12-month follow-up. After approximately 22 months, mortality was lower in the enzalatumide group vs the placebo group (28% vs 35%, respectively), a 29% reduction in risk of death among men taking the drug. Benefits in secondary end points were also noted, including 17-month improvement in median time to initiation of chemotherapy and a reduced risk of a first skeletal-related event.

Enzalutamide Improves Survival in Patients with Advanced Prostate Cancer
Enzalutamide Improves Survival in Patients with Advanced Prostate Cancer
In an international randomized phase III clinical trial, the hormone therapy enzalutamide (Xtandi®) extended survival in men with metastatic prostate cancer that had progressed during treatment with androgen deprivation therapy. However, chemotherapy is not a treatment option for many men with pre-existing medical conditions or who cannot tolerate the side effects.
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