Enzalutamide (Xtandi) for patients with metastatic, resistant prostate cancer.
OBJECTIVE
To review the pharmacology and pharmacokinetics, and to evaluate the clinical efficacy, safety, and place in therapy of enzalutamide for the treatment of castration-resistant prostate cancer (CRPC).


METHODS
A literature search through PubMed (1984 to November 2013; English language) was performed using the following keywords: MDV3100, androgen deprivation therapy, enzalutamide, CRPC, and androgen receptor antagonist. Searches were limited to published studies in humans.


METHODS
All articles in English identified from reviews, abstracts, presentations, and clinical trials of enzalutamide in humans were selected and included.


RESULTS
Enzalutamide is an oral, nonsteroidal second-generation androgen receptor antagonist that is Food and Drug Administration-approved for the treatment of metastatic CRPC in men who were previously treated with docetaxel. Enzalutamide was superior to placebo for increasing median survival from 13.6 months to 18.4 months. Enzalutamide was well tolerated at a dose of 160 mg, with minor adverse events such as fatigue, diarrhea, musculoskeletal pain, and hot flashes. Patients with increased risk of seizure should not take enzalutamide.


CONCLUSIONS
Enzalutamide is effective to slow progression of metastatic CRPC, to reduce prostate-specific antigen (PSA) levels, to decrease time to progression of PSA, to increase time to first skeletal-related events, and to increase quality of response rate. Enzalutamide was given at 160 mg/d for a median of 8 cycles of administration. Clinical trials are currently being conducted to observe if enzalutamide will be useful for treatment of other cancers and for early administration in prostate cancer.
Union University, Jackson, TN, USA.
Lunawati L
LL
Bennett
April
A
Ingason
D059002:Androgen Receptor Antagonists / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D001549:Benzamides; D002986:Clinical Trials as Topic; D018450:Disease Progression; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009570:Nitriles; D010669:Phenylthiohydantoin / Q000031:analogs & derivatives* / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology
D059002:Androgen Receptor Antagonists; D000970:Antineoplastic Agents; D001549:Benzamides; D009570:Nitriles; D010669:Phenylthiohydantoin; C540278:enzalutamide
MDV3100; androgen deprivation therapy; androgen receptor antagonist; antiandrogen; castration-resistant prostate cancer; enzalutamide