Cancer Treatment Today

XTANDI (enzalutamide) is an androgen receptor inhibitor that was indicated for the treatment of patients with castration-resistant prostate cancer (CRPC) and metastatic castration-sensitive prostate cancer (mCSPC).. However, in December 2019, XTANDI (enzalutamide) is an androgen receptor inhibitor indicated for the treatment of patients with castration-resistant prostate cancer (CRPC) and metastatic castration-sensitive prostate cancer (mCSPC). Data from the ARCHES trial demonstrated that the use of XTANDI plus androgen deprivation therapy (ADT) significantly reduced the risk of radiographic progression or death by 61 percent compared to placebo plus ADT (n=1,150; hazard ratio [HR]: 0.39 [95% confidence interval (CI): 0.30-0.50]; p<0.0001). Overall survival data were not mature at the time of final rPFS analysis.

The safety analysis of the ARCHES trial is generally consistent with the safety profile of XTANDI in previous clinical trials in CRPC. In ARCHES, common adverse reactions (Grade 1 to 4 ARs; occurring in at least 5% of patients) that were reported more frequently in patients treated with XTANDI plus ADT vs placebo plus ADT included hot flush (27% vs 22%), asthenic conditions (24% vs 20%), hypertension (8.0% vs 5.6%), fractures (6.5% vs 4.2%), and musculoskeletal pain (6.3% vs 4.0%).

Fizazi K, Tran N, Fein L et al. Abiraterone plus prednisone in metastatic, castrationsensitive prostate cancer. N Engl J Med 2017;377:35260

ttps://www.urotoday.com/conference-highlights/asco-gu-2019/asco-gu-2019-prostate-cancer/110267-asco-gu-2019-phase-3-study-of-androgen-deprivation-therapy-adt-with-enzalutamide-enza-or-placebo-pbo-in-metastatic-hormone-sensitive-prostate-cancer-mhspc-the-arches-trial.html

NCCN Prostate Cancer 2020