Metastatic Prostate Cancer: New Androgen Blocker Improved Survival, Quality of Life

Tomasz M. Beer, M.D. FACP OHSU Knight Cancer Institute, Oregon Health and Science University OR Interview with:
Tomasz M. Beer, M.D. FACP
OHSU Knight Cancer Institute
Oregon Health and Science University
OR 97239

Medical Research: What are the main findings of the study?

Dr. Beer: In the study, we found that compared to placebo, enzalutamide improves overall survival, progression-free survival, quality of life, and delays the need for chemotherapy. Enzalutamide is superior to placebo with respect to all planned endpoints, across all subsets of the patient population in the study.  Enzalutamide treatment is associated with an excellent safety profile.

Medical Research: Were any of the findings unexpected?

Dr. Beer: The findings are precisely what we hoped for when we designed the trial.  There were no major surprises. The response rate in patients with soft tissue measurable disease was high, which was a bit surprising.

Medical Research: What should clinicians and patients take away from your report?

Dr. Beer: Provided that the FDA approves it in this setting, enzalutamide is an excellent treatment option for men with metastatic castration resistant prostate cancer prior to chemotherapy.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Beer: Future research should focus on understanding mechanisms of treatment resistance so that treatment can be further improved, perhaps by designing combinations of enzalutmide with other agents.  The use of enzalutamide in other setting in prostate cancer, including front line hormonal therapy, should also be evaluated.


Enzalutamide in Metastatic Prostate Cancer before Chemotherapy
Tomasz M. Beer, M.D., Andrew J. Armstrong, M.D., Sc.M., Dana E. Rathkopf, M.D., Yohann Loriot, M.D., Cora N. Sternberg, M.D., Celestia S. Higano, M.D., Peter Iversen, M.D., Suman Bhattacharya, Ph.D., Joan Carles, M.D., Ph.D., Simon Chowdhury, M.D., Ph.D., Ian D. Davis, M.B., B.S., Ph.D., Johann S. de Bono, M.B., Ch.B., Ph.D., Christopher P. Evans, M.D., Karim Fizazi, M.D., Ph.D., Anthony M. Joshua, M.B., B.S., Ph.D., Choung-Soo Kim, M.D., Ph.D., Go Kimura, M.D., Ph.D., Paul Mainwaring, M.B., B.S., M.D., Harry Mansbach, M.D., Kurt Miller, M.D., Sarah B. Noonberg, M.D., Ph.D., Frank Perabo, M.D., Ph.D., De Phung, B.S., Fred Saad, M.D., Howard I. Scher, M.D., Mary-Ellen Taplin, M.D., Peter M. Venner, M.D., and Bertrand Tombal, M.D., Ph.D. for the PREVAIL Investigators

June 1, 2014DOI: 10.1056/NEJMoa1405095