Enzalutamide is an androgen receptor-signaling inhibitor that is reported to differ from conventional antiandrogen agents in that it inhibits androgen receptor nuclear translocation, DNA binding, and coactivator recruitment; exhibits increased affinity for the androgen receptor; and induces tumor reduction, rather than slowing growth, in preclinical models. The recently reported AFFIRM study showed that enzalutamide treatment after chemotherapy significantly prolonged overall survival (OS), radiographic progression-free survival (PFS), time to prostate-specific antigen (PSA) progression, and time to skeletal-related events (SREs) in men with castration-resistant prostate cancer. This trial formed the basis for the recent approval of enzalutamide for the treatment of patients with metastatic castrationresistant prostate cancer who have previously received docetaxel.
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