Enzalutamide — a new agent for treatment of castration-resistant prostate cancer

Abstract

Systemic treatment of prostate cancer is primarily based on androgen deprivation (surgical/pharmacological castration) which reflects hormone-dependent biology of this malignancy. Despite significant activity of hormonal therapy in advanced prostate cancer, the progression of disease in the majority of castrated patients is inevitable.This phenomenon results from development of intrinsic mechanisms of resistance to systemic androgen deprivation. Elucidation of the molecular mechanisms of resistance has paved way toward development of novel, targeted hormonal agents. Two years ago, abiraterone acetate was approved in EU for treatment of castration-resistant prostate cancer following docetaxel. In 2013, EMEA approved a second drug — enzalutamide (an extremely strong antiandrogen) for second-line treatment of CRPC. Both drugs — enzalutamide and abiraterone acetate have significantly improved prognosis of advanced CRPC patients.