Combination Therapy with Enzalutamide Significantly Improves Survival in Advanced Prostate Cancer Patients

A recent five-year follow-up study from the Duke Cancer Institute has revealed that the combination of enzalutamide and androgen deprivation therapy (ADT) greatly enhances survival rates for men suffering from metastatic hormone-sensitive prostate cancer. This extensive research builds on the findings of the global ARCHES study, demonstrating significant improvements in life expectancy for patients undergoing this treatment.

According to the findings, the five-year survival rate for men diagnosed with high-volume disease--characterized by five or more bone metastases or cancer that has metastasized to vital organs such as the liver or lungs--increased by 13%. Notably, these patients typically have the poorest prognosis following diagnosis. The therapy has been shown to extend their average lifespan from approximately four years to seven years.

For patients with low-volume disease, the survival rate improved by 9%, with over 75% of these individuals living beyond the five-year mark under this new treatment regimen. The lead researcher emphasized that such a substantial median improvement in survival is unprecedented in prostate cancer trials, highlighting the significant impact of this combination therapy on patient quality of life and longevity.

Enzalutamide, which received FDA approval in 2019 for use in patients with castration-resistant prostate cancer, works by blocking androgen receptors, effectively preventing testosterone from aiding the survival and growth of cancer cells. The ARCHES study enrolled 1,150 participants from various locations around the world. Participants were randomly assigned to either receive the combination therapy or a placebo along with ADT.

After five years, the survival probability for men treated with both enzalutamide and ADT was recorded at 66%, compared to 53% for those who received hormone therapy alone. Furthermore, the risk of mortality decreased by 30% among patients undergoing the more intensive hormonal treatment as opposed to the placebo group.

This analysis of long-term survival benefits underscores the necessity for treatment intensification for all patients diagnosed with metastatic hormone-sensitive prostate cancer. The data suggests that patients should not settle for traditional hormonal therapy with ADT alone, except in rare cases, as the standard of care now emphasizes a more aggressive treatment approach.

The results of this study will be formally presented at the upcoming American Society of Clinical Oncology annual meeting in Chicago, further solidifying the growing body of evidence supporting the efficacy of enzalutamide in extending the lives of patients with advanced prostate cancer.