Prostate cancer is a common form of cancer among men. Though early diagnosis and treatment can lead to complete remission, late-stage prostate cancer that has metastasized can be difficult to treat.

Enzalutamide has shown promising results in the treatment of metastatic prostate cancer.

What is Enzalutamide?

Enzalutamide is a nonsteroidal antiandrogen drug that was initially approved by the FDA in 2012. It is used in the treatment of advanced prostate cancer that has spread to other parts of the body.

It works by blocking the androgen receptors, which are responsible for the growth of prostate cancer cells.

Clinical Trials of Enzalutamide in Metastatic Prostate Cancer

Several clinical trials have been conducted to study the efficacy of enzalutamide in the treatment of metastatic prostate cancer.

The most notable of these is the PREVAIL trial, which involved 1,717 men with metastatic prostate cancer who had not received chemotherapy. The study found that enzalutamide significantly improved overall survival, delaying the progression of the cancer by nearly 4 months compared to a placebo.

Side Effects of Enzalutamide

Like any drug, enzalutamide has side effects. The most common ones reported are fatigue, weakness, hot flashes, and hypertension.

Enzalutamide can also lead to seizures, which is why it is contraindicated in patients with a history of seizures or epilepsy.

Combination Therapy with Enzalutamide

Enzalutamide can also be used in combination with other drugs to enhance its efficacy. One such combination therapy is enzalutamide and abiraterone.

Abiraterone is another antiandrogen drug that works by inhibiting the production of testosterone, which fuels the growth of prostate cancer cells. Studies have found that the combination of the two drugs is more effective in treating metastatic prostate cancer compared to either drug alone.

Enzalutamide Resistance

Like all cancer treatments, enzalutamide can lead to drug resistance, where the cancer becomes resistant to the drug’s effects. Several studies have been conducted to understand the mechanism of enzalutamide resistance.

One study found that the activation of a protein called Wnt5a plays a role in enzalutamide resistance. The researchers suggested that targeting Wnt5a could help sensitize the cancer cells to enzalutamide again.

New Developments in Enzalutamide Therapy

Researchers continue to study enzalutamide to improve its efficacy and reduce side effects. In 2020, a study was conducted to study the pharmacokinetics and pharmacodynamics of enzalutamide and its metabolite N-desmethyl enzalutamide.

The study found that N-desmethyl enzalutamide was as effective as enzalutamide in blocking androgen receptors. The researchers suggested that N-desmethyl enzalutamide could be a potential alternative for patients who experience side effects from enzalutamide.

Conclusion

Enzalutamide has shown promising results in the treatment of metastatic prostate cancer. While it does have side effects, the benefits outweigh the risks for patients who need it.

Further research is necessary to understand enzalutamide resistance and improve the effectiveness of enzalutamide therapy.