Oncology Advances

NewYork-Presbyterian

Advances in Oncology

Prolonging Life for Men with Prostate Cancer

In the June 4, 2020, issue of The New England Journal of Medicine, Weill Cornell Medicine faculty reported on very promising results of a phase 3 clinical trial focused on overall survival in men with nonmetastatic, castration-resistant prostate cancer whose PSA levels doubled within 10 months. The study, led by Cora N. Sternberg, MD, a specialist in urologic cancer and Clinical Director of the Englander Institute for Precision Medicine at Weill Cornell, is the PROSPER study of enzalutamide – an androgen receptor inhibitor – in patients with nonmetastatic castration-resistant prostate cancer.

In 2018, the FDA approved enzalutamide in combination with androgen-deprivation therapy to treat nonmetastatic, castration-resistant prostate cancer based on results of the PROSPER phase 3 trial, which showed a significantly lower risk of metastasis or death without radiographic progression than with androgen-deprivation therapy alone. And while this was clearly encouraging, data on overall survival was immature.

Analysis of overall survival in the current phase 3 trial, conducted at more than 250 sites in 32 countries around the world, demonstrated that treatment with enzalutamide was associated with a significant 27 percent lower risk of death than placebo in men than those only receiving androgen-deprivation therapy, despite the use of subsequent life-prolonging antineoplastic therapies (including enzalutamide) by patients in the placebo group. Additionally, the time to subsequent antineoplastic therapy, time to cytotoxic chemotherapy, and chemotherapy-free survival were also longer in the enzalutamide group than in the placebo group.

According to the authors, “These results add to the growing body of evidence that androgen-receptor inhibitors not only delay the time to metastasis but also improve overall survival among men with nonmetastatic, castration-resistant prostate cancer.”

Read more at Enzalutamide and Survival in Nonmetastatic, Castration-Resistant Prostate Cancer: https://www.nejm.org/doi/full/10.1056/NEJMoa2003892