Dr. Freedland on Real-World Utility of Enzalutamide in Prostate Cancer

Stephen J. Freedland, MD, Warschaw Robertson Law Families Chair in Prostate Cancer; director of the Center for Integrated Research in Cancer and Lifestyle; co-director of the Cancer Genetics and Prevention Program; associate director of the Faculty Development Samuel Oschin Comprehensive Cancer Institute; and professor of surgery at Cedars-Sinai, discusses remaining questions with the real-world utility of enzalutamide (Xtandi) in prostate cancer.

Data from multiple phase 3 trials have demonstrated that enzalutamide is a novel therapy for prostate cancer, specifically in the metastatic castration-sensitive, nonmetastatic, and metastatic castration-resistant settings, says Freedland. Clinical trial data have shown that the agent surprises androgen signaling, reduces prostate-specific antigen, and slows tumor growth, which improves overall survival for patients, explains Freedland.

However, how this agent will be utilized in the real-world settingremains an open question. The trials that have examined the agent thus far are highly selective; they accrue healthy patients who adhere to the medicine and get their blood tests done on time, says Freedland. The question of whether similar efficacy will be seen in the real world with regard to PSA control and time to progression remains open, concludes Freedland.