Phase II Study of ENZAlutamide Combined With Hypofractionated Radiation Therapy (ENZART) for Localized Intermediate Risk Prostate Cancer
Lara, Pedro C. (Centro Oncológico Integral de Canarias. Hospital Universitario San Roque. Universidad Fernando Pessoa Canarias)
Rodríguez-Melcón, Juan I. (Hospital Universitario de Gran Canaria Dr. Negrín)
Palacios-Eito, Amalia (Hospital Universitario "Reina Sofía" (Còrdova). Instituto Maimónides de Investigación Biomédica de Córdoba. Oncología Radioterápica)
Lozano, Antonio (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Hervás-Morón, Asunción (Hospital Universitario Ramón y Cajal (Madrid))
Villafranca, Elena (Hospital Universitario de Navarra. Oncología Radioterápica)
Gómez-Iturriaga, Alfonso (Hospital Universitario de Cruces (Barakaldo, País Basc))
Sancho-Pardo, Gemma (Institut d'Investigació Biomèdica Sant Pau)
Maldonado, Xavier (Vall d'Hebron Institut d'Oncologia)

Data:	2022
Resum:	Background: Intermediate-risk prostate cancer (PCa) is usually treated by a combination of external beam radiation therapy (EBRT) and a short course of androgen deprivation therapy (ADT). ADT is associated with multiple side effects, including weight gain, loss of libido, and hot flashes. In contrast, anti-androgen monotherapy is generally better tolerated in spite of higher rates of gynecomastia. Objective: This study assessed the effectiveness of enzalutamide monotherapy combined with hypofractionated EBRT (Hypo-EBRT) for treating intermediate risk prostate cancer. Method: This trial was a multicenter, open-label phase II study of 6 months of enzalutamide monotherapy combined with Hypo-EBRT for intermediate-risk prostate cancer. Hypo-EBRT was initiated 8-12 weeks after initiating enzalutamide. The primary endpoint was PSA decline >80% measured at the 25th week of enzalutamide administration. Secondary end-points included assessment of toxicity, changes in anthropomorphic body measurements, sexual hormones, and metabolic changes. Results: Sixty-two patients were included in the study from January 2018 to February 2020. A PSA decline of >80% was observed in all evaluable patients at the end of enzalutamide treatment and 92% achieved PSA values under 0. 1 ngr/ml. All patients remain in PSA response (<80% reduction of the initial values) 6 months after the end of enzalutamide treatment. The most frequent adverse events were hypertension, asthenia, and gynecomastia. There were no significant changes in bone density, body mass index (BMI), or patient-reported outcomes (PROs). Conclusion: Enzalutamide monotherapy is very effective along with hEBRT in reducing PSA levels for patients with intermediate-risk prostate cancer. Longer follow-up is needed to confirm the potential use of this combination in future randomized trials.
Nota:	Altres ajuts: Astellas.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Prostate cancer ; Intermediate risk ; Enzalutamide monotherapy ; Hypofractionated ; Radiotherapy
Publicat a:	Frontiers in Oncology, Vol. 12 (July 2022) , p. 891886, ISSN 2234-943X

DOI: 10.3389/fonc.2022.891886
PMID: 35912190

12 p, 1.1 MB

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