Comment: Using enzalutamide will allow patients to avoid chemotherapy and steroids improving quality of life

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Published: 2 Jun 2019
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Dr Neeraj Agarwal - Huntsman Cancer Institute, Salt Lake City, USA

Dr Neeraj Agarwal comments on data, during a press conference at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, from the ENZAMET trial.

This was a phase III internationally randomised trial in which patients with mHSPC who received testosterone suppression were also given enzalutamide.

Watch Dr Sweeney's press conference here, and interview here.

Advanced prostate cancer is the second most common cause of cancer-related deaths in American men. The current treatment options for men with newly diagnosed advanced prostate cancer include chemotherapy, as Dr Sweeney mentioned, or an oral pill, abiraterone, which requires concomitant use of steroids for many years.

What we saw in this study is that enzalutamide, or enza to make it simple, an oral pill which is a novel class of drugs for these men and targets AR, androgen receptor, a protein which is critical for disease progression in these patients, targeting AR with enzalutamide improved the overall survival in a very remarkable fashion. Remarkably their disease free survival were also delayed.

So what are the implications of this study or how do we analyse the findings in a simple perspective? In my view, using enzalutamide early on will allow our patients to avoid chemotherapy and steroids for many years, thus hopefully improve their quality of life. Of course, one positive study is encouraging but two large studies, as Dr Sweeney mentioned again, demonstrating similar findings is even better. In this meeting we saw the data for apalutamide, a similar drug, with an equally impressive margin of benefit. This increases my confidence that targeting AR, this protein, is the optimal approach for newly diagnosed patients with advanced prostate cancer.