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From the Spring 2019 Quest
Patients with metastatic hormone sensitive prostate cancer have a disease that has already spread out of their prostate, yet the cancer is still responding to androgen deprivation therapy (ADT), also known as hormonal therapy. The ARCHES trial recently reported that patients with this type of disease had significantly better results if they took the secondary hormonal therapy drug, enzalutamide (trade name Xtandi), in combination with ADT.

The ARCHES trial randomized 1,150 patients with metastatic hormone-sensitive prostate cancer to received ADT with enzalutamide or ADT with a placebo. After a median follow-up of 14.4 months, patients who took enzalutamide and ADT were living longer without their disease progressing. Over time, they had a 61% better chance of their cancer not progressing or not dying from the disease.

Patients who took enzalutamide also saw a benefit to their PSA scores. Men who took enzalutamide had an 81% better risk of their PSA not increasing during the trial. Also, 68.1% of the men in the enzalutamide group achieved an undetectable PSA rate, compared to only 17.6% of men in the placebo group.

This study also found that enzalutamide was effective for patients with low- and high-volume disease. Previous studies have looked at enzalutamide in men with only high volume disease.

ADT is typically used to delay the progression of prostate cancer that has spread
too far to be cured by surgery or radiation, or if cancer comes back. ADT blocks
male sex hormones called androgens, as lowering the levels of these hormones
can slow the cancer’s growth.

J Clin Oncol 37, 2019 (suppl 7S; abstr 687)

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