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Enzalutamide vs Active Surveillance for Prostate Cancer


Clinical trial shows that enzalutamide reduces risk of prostate cancer progression by 46 percent

Prostate cancer is a type of cancer that develops in the prostate gland, which is a small gland located between the bladder and the penis in men. It is the most common cancer in men, but most men who develop prostate cancer do not die from it.

Low-risk or intermediate-risk prostate cancer means that the cancer is not very aggressive and is unlikely to spread to other parts of the body. Active surveillance is a treatment option for these patients because they may not need immediate treatment. Instead, doctors monitor the cancer to see if it becomes worse.

Enzalutamide is a medication that is used to treat prostate cancer. It works by blocking the effects of male hormones, which can fuel the growth of prostate cancer cells. The medication is usually used when other treatments, such as surgery or radiation therapy, have not worked or are not appropriate.

A clinical trial has compared two different treatment options for patients with prostate cancer. The trial looked at how well enzalutamide worked compared to active surveillance. Active surveillance means that doctors keep an eye on cancer but do not give any treatment unless it becomes necessary.

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The trial included 227 patients with low-risk or intermediate-risk prostate cancer. The patients were split into two groups. One group received enzalutamide for one year, and the other group received active surveillance. The patients were monitored for one year during treatment and up to two years after treatment.


The trial found that enzalutamide was safe to use and reduced the risk of prostate cancer progression by 46% compared to active surveillance alone. Prostate cancer progression is when cancer becomes worse and requires more treatment. This means that enzalutamide may be a good option for patients with low-risk or intermediate-risk prostate cancer who are on active surveillance.

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The trial also found that enzalutamide reduced the percentage of cancer-positive cores, which are small pieces of tissue taken from the prostate gland. Additionally, the medication increased the chances of a negative biopsy result, which means that there was no sign of cancer in the biopsy. Enzalutamide also delayed PSA progression by six months compared to active surveillance. PSA is a protein made by the prostate gland, and an increase in PSA levels can indicate prostate cancer progression.

Overall, the trial found that enzalutamide was well-tolerated and provided a significant treatment response for patients with low-risk or intermediate-risk localized prostate cancer. The medication may be a good alternative to active surveillance for these patients.

The most commonly reported side effects during enzalutamide treatment were fatigue and gynecomastia. Fatigue is feeling very tired or weak, and gynecomastia is when men develop breast tissue. However, no deaths were considered to be related to the medication.


The trial concluded that enzalutamide may be a good treatment option for patients with low-risk or intermediate-risk prostate cancer who are on active surveillance. The medication was well-tolerated and reduced the risk of prostate cancer progression by 46% compared to active surveillance alone. However, like all medications, enzalutamide can have side effects, such as fatigue and gynecomastia. It is important for patients to talk to their doctors about the benefits and risks of enzalutamide and other treatment options for prostate cancer.


JAMA Network, Jun-16-22
ClinicalTrials.gov, NCT02799745

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This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. CenTrial Data Ltd. does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. Treatments and clinical trials mentioned may not be appropriate or available for all trial participants. Outcomes from treatments and clinical trials may vary from person to person. Consult with your doctor as to whether a clinical trial is a suitable option for your condition. Assistance from generative AI tools may have been used in writing this article.