Novel Combination Therapy in Recurrent Prostate Cancer: A Game Changer

Enzalutamide added to standard androgen‑deprivation therapy reduced the risk of death by more than 40% in men with high‑risk biochemically recurrent prostate cancer, demonstrating a durable overall‑survival advantage, according to recent research.

The international randomized trial enrolled more than 1,000 patients across 244 sites in 17 countries, supporting broad applicability. Patients were randomized to enzalutamide plus standard hormone therapy versus standard hormone therapy alone, with study treatment given concurrently with androgen‑deprivation therapy. Overall survival was a prespecified primary endpoint in the analysis.

Safety signals included higher rates of grade ≥3 adverse events and a trend toward increased treatment discontinuation in the combination arm. Clinically, that magnitude of overall‑survival benefit requires weighing against the toxicity profile when selecting patients—particularly those with truly high‑risk biochemical recurrence.

For clinical practice, the implications are clear: men with high‑risk biochemically recurrent disease are the primary group affected, and the data support considering earlier combination therapy in carefully selected patients.

Absent full peer‑review and guideline‑panel endorsement, broad adoption should await publication and formal guideline reassessment, though tumor boards and shared decision‑making will likely begin integrating these results in the near term.

Key Takeaways:

• Trial‑reported >40% reduction in risk of death with enzalutamide plus standard hormone therapy in high‑risk biochemically recurrent prostate cancer.
• Patients with high‑risk biochemical recurrence; the study enrolled >1,000 patients across 244 sites in 17 countries.
• Likely reassessment of standards for selected high‑risk recurrent patients pending peer review and guideline updates; expect multidisciplinary discussion and case‑by‑case adoption.
• Peer‑reviewed publication with full safety tables, longer follow‑up, and guideline‑panel review to define broader use and selection criteria.