The ENZAMET trial tested the drugs enzalutamide (Xtandi) and the TITAN test with aplatamide (Erlada) in men whose cancer is still responsible for hormone-suppressing therapies — also known as castration-sensitive cancers. In both trials, combining related medications with androgen deprivation therapy (ADT) significantly improved how long men survived and how long they worsened without cancer.
The results of both tests were also published simultaneously in the New England Journal of Medicine.
Enzulatamide and apalutamide are already approved by the Food and Drug Administration for the treatment of prostate cancer that no longer responds to treatments that lower hormone-androgen levels, which are referred to as hormone-resistant (or castration-resistant) disease Is known in These approvals are expected to expand based on these new figures.
From a treatment standpoint, the findings of the trials now mean “there are more treatment options for patients,” said William Dahut, the clinical director of NCI’s Cancer Research Center, which specializes in treating prostate cancer Are, but were not included in both studies.
Speaking at the ASCO meeting, Tanya Dorf, MD, agreed to head the genitourinary cancer program at the City of Hope Comprehensive Cancer Center in California. The tests also confirm the value of intensive treatment in men with hormone-sensitive metastatic prostate cancer.
men diagnosed with metastatic hormone-sensitive prostate cancer , a major treatment shift over five years , the cancer is usually induced to grow and spread by androgens that are produced extensively in the testes. For many years, treatment that blocks androgen production has been a mainstay for the diagnosis of metastatic prostate cancer for men from the beginning.
Started in 2014, which began to change after a large clinical trial showed that adding the chemotherapy drug docetaxel to ADT improved long-term men with hormone-responsive disease. Shortly afterwards, another clinical trial showed that the induction of ADTR (Zyta) in ADT also improved survival in these men, although mainly in men with multiple metastatic tumors who had high-volume disease. Is known as
However, docetaxel, which acts directly to kill cancer cells,
can have substantial side effects, and some patients are not healthy enough to tolerate it. And abiraterone — which blocks androgen production throughout the body — can cause side effects including those affecting the liver. It is also to be given in combination with the steroid prednisone, which performs its toxicity.
Enzalutamide and Apalutamide block the androgen receptor on cancer cells, the ability of androgens to promote prostate cancer development. The efficacy of the drugs in hormone-resistant metastatic prostate cancer prompted researchers to test them in men with less advanced disease.
In doing so, Drs. Chi said during the presentation of TITAN data at the ASCO meeting, may help prevent the generally unavoidable development of hormone-resistant cancer, which is more difficult to treat and a major cause of prostate cancer deaths. Is the driver.
The improvement of how long patients live
was tested by ENZAMET — funded by drug manufacturer Astellas Pharma as well as government health agencies in Canada and Australia, with more than 1,100 men with hormone-sensitive metastatic prostate cancer (largely in the United States Out of) were nominated. Males were randomly assigned to ADT with enzalutamide or with three other androgen-inhibiting drugs.
In the median period of approximately 3 years, men receiving ADT plus enziletamide had a 33% lower risk of death, with 80% still living, as well as 72% of men treated with ADT Plus and another antiandrogen drug Was, the principal investigator of the test reported. , Christopher Sweeney, MBBS of the Dana-Farber Cancer Institute.
For prostate cancer, whichever came first. At 3 years, 63% of men in the enzalutamide group were alive without clinical progression of their disease, compared to 33% in the standard treatment group.