Concurrent Enzalutamide, Salvage Radiotherapy, and ADT in High-Risk Prostate Cancer
Posted: Monday, May 4, 2020
According to research published in European Urology Oncology, concurrent enzalutamide, salvage radiotherapy, and androgen-deprivation therapy (ADT) is safe for use in patients with high-risk recurrent prostate cancer. The 3-year trial focused on men with prostate-specific antigen (PSA) recurrence within 4 years of undergoing radical prostatectomy and an elevated Gleason score.
“Salvage [radiotherapy] with enzalutamide and ADT following [radical prostatectomy] for men with PSA recurrent high-risk [prostate cancer]…demonstrates encouraging efficacy, warranting prospective controlled phase II trials of ADT with or without potent androgen receptor inhibition in this curative-intent setting,” concluded Rhonda L. Bitting, MD, of Wake Forest University, Winston-Salem, and colleagues.
The study focused on 37 men with prostate cancer who had a Gleason score between 7 and 10 and who had PSA recurrence of between 0.2 and 4.0 ng/mL within 4 years of undergoing radical prostatectomy. The 2-year progression-free survival was 65% (95% confidence interval [CI] = 47%–78%), superior to the 51% achieved in a similar trial where docetaxel was used in place of enzalutamide (95% CI = 33%–67%). Progression-free survival at 3 years was 53%.
No unexpected toxicities were reported. A total of 29% of patients (n = 11) experienced grade 3 toxicities, but no toxicities of a higher grade were observed. According to quality-of-life data, a slight increase in bowel, bladder, and hormonal symptoms occurred around 3 months but resolved by 24 months for the majority of affected patients.
“Addition of 6 months of oral daily enzalutamide to standard salvage radiation and hormone therapy…may improve prostate cancer remission rates at 2 and 3 years,” the study authors concluded.
Disclosure: For full disclosures of the study authors, visit euoncology.europeanurology.com.
