Five-Year Follow-Up Shows Enzalutamide Extends Survival in Men with Advanced Prostate Cancer

Recent research from Duke University highlights the significant benefits of combining enzalutamide with androgen deprivation therapy (ADT) for men battling metastatic hormone-sensitive prostate cancer. The five-year follow-up of the global ARCHES clinical trial demonstrates that this combination therapy substantially improves survival rates compared to hormone therapy alone.

The study revealed that men with high-volume disease — characterized by five or more bone metastases or spread to the liver or lungs — experienced a 13% increase in five-year survival rates. Notably, for these patients, the average extension of life was three additional years, increasing from approximately four to seven years. Patients with low-volume disease also saw a 9% improvement, with more than 75% living beyond five years with this treatment.

Lead researcher Dr. Andrew Armstrong emphasized the groundbreaking nature of these findings, stating, "We haven't seen this level of median survival improvement in any other prostate cancer trial. An extra three years on average is a remarkable milestone for patients."

In 2019, the FDA approved enzalutamide for castration-resistant prostate cancer based on earlier ARCHES trial results. That study involved 1,150 men worldwide, randomized to receive either the combination of enzalutamide and ADT or ADT with a placebo. After five years, those on the combination therapy had a 66% chance of survival versus 53% in the placebo group, with a 30% reduction in the risk of death.

Enzalutamide functions by blocking the androgen receptor, which impedes testosterone's role in supporting cancer cell growth. Its effectiveness was consistent regardless of age, extent of disease spread, prior treatments like chemotherapy, or whether cancer had metastasized to lymph nodes or bones.

Dr. Armstrong advocates for treatment intensification from the outset, stating, "This data clearly indicates that all patients should be offered this more aggressive approach rather than the traditional hormone therapy alone." The long-term survival benefits will be formally presented at the upcoming American Society of Clinical Oncology annual meeting in Chicago.

Source: https://medicalxpress.com/news/2025-05-enzalutamide-life-men-advanced-prostate.html