Enzalutamide—A boon to cure high-risk non-metastatic castration-resistant prostate cancer

Prostate cancer is the second most commonly occurring cancer in American men. Naturally, it originates in the prostate gland and spreads to the lymph nodes and other parts of the body gradually. In most of the early stages of prostate cancers, testosterone is required for the disease to spread. However, that is not the case in castrate-resistant prostate cancer. Even if the testosterone level is reduced to the lowest levels in the body, cancer keeps on growing. Mention may also be made that approximately 10-20% of the total number of diagnosed cases turn out to castrate-resistant. 

Through several clinical trials, the efficiency of several life-saving (or prolonging) metastatic castration-resistant prostate cancer therapies has been established. At the same time, it can also be said that the real-world application, data on survival effect and safety are still limited. According to recent findings, it has been proved that Enzalutamide has been successfully proven to be helpful for men with mCRPC rather than watchful observation with the conventional androgen deprivation therapy. 

How is enzalutamide helpful for men with high-risk non-metastatic castration-resistant prostate cancer? 

A retrospective and non-interventional cohort analysis of electronic health record data of patients with mCRPC was conducted with the primary objective of describing the real-world treatment types, patterns, approximate duration and sequencing. The secondary objective of the study was to describe patient characteristics and clinical outcomes. A total of 2559 patients participated in the study out of which 77% was treated with 1 line of life-prolonging therapy. Among them, 49% got second-line therapy and 43%, third line. Abiraterone and Enzalutamide were present in 65% of first-line and 54% of second-line therapies with Docetaxel as the most common third-line therapy. 

Results 

With back to back the use of Abiraterone 250 mg and Enzalutamide 40 mg , the median overall survival was discovered to be much longer in patients who underwent the life-prolonging therapies (23.7 months) while the ones who did not have a median overall survival of 10.1 months. Therefore, the outcome category of mortality has an added advantage which proved that the patients who were treated with Enzalutamide survived longer than patients who were at the comparator wing of the study. Though the medication proved to be efficient in the treatment for renal and urinary disorders, the line between the symptoms of the disease and side effects of the drug has not yet been drawn clearly. 

Just like the added advantage, there are also disadvantages of this drug compared to the watchful observation along with androgen deprivation therapy. The extent of the side effects was considered to be minor to significant. However, researchers did not consider these to be severe because the overall assessment suggested longer survival. 

Frequently asked questions:

What is Enzalutamide? 
Enzalutamide specifically is an androgen receptor inhibitor. Within the tumor cells it acts on the multiple steps of the androgen receptor signaling pathway.

What is the mode of action for Enzalutamide? 
Enzalutamide basically inhibits the androgen binding to the androgen receptor, inhibits the androgen receptors from entering the nucleus, and inhibits the androgen receptor binding to the DNA.

What is the recommended dosing for Enzalutamide?
Enzalutamide is recommended to be taken as 160 mg (four 40mg capsules, four 40mg tablets, or two 80mg tablets) orally, once in a day.

Why is Enzalutamide introducing a tablet formulation? 
The form of tablet of Enzalutamide specifically offers patients the following:

• Smaller pills: Tablets are smaller in comparison to the capsule.
• More dosing options: The tablets come in a couple of strengths, 40mg and 80mg.
• An option with fewer pills: The daily recommended dosage is 160mg (four 40mg or two 80mg tablets)
• Tablets should be swallowed whole. Chewing, cutting, or crushing of tablets needs to be avoided. 

Does Enzalutamide have the overall survival findings? 
Yes, Enzalutamide has overall survival findings in nmCRPC and mCRPC.
In mCSPC, the ARCHES trial overall survival findings were immature at the time of rPFS analysis (7.3% of deaths in the intent-to-treat population noted).

What are the most common side effects in patients treated with Enzalutamide? 
On behalf of findings from 4 randomized placebo-controlled trials, the most common side effects that reported more frequently in patients treated with enzalutamide are hot flush, fatigue, back pain, decreased appetite, constipation, arthralgia, hypertension and diarrhea. On behalf of bicalutamide-controlled study, the most common side effects reported in patients treated with enzalutamide are back pain, fatigue, musculoskeletal pain, hot flush, nausea, constipation, hypertension, diarrhea, weight loss and upper respiratory tract infection. 

NOTE: The piece of information mentioned about "ENZALUTAMIDE: A BOON TO CURE HIGH-RISK NON-METASTATIC CASTRATION-RESISTANT PROSTATE CANCER" in this article is just for the informational purposes and is not served as a substitute for medical treatment, consultation, diagnosis of a qualified doctor.

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