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Cancer research

New Prostate Cancer Findings from Duke Cancer Institute

Strategic Insights

— 2 min read

According to a recent study published in JAMA Network Open, researchers from the Duke Cancer Institute have made new discoveries regarding the treatment of metastatic hormone-sensitive prostate cancer. The study, which analyzed data from the ARCHES randomized clinical trial, found that men with prostate cancer who received enzalutamide plus androgen deprivation therapy (ADT) had improved survival rates when their prostate-specific antigen (PSA) levels decreased after treatment. However, the study also found that the PSA levels at enrollment and the degree of PSA reduction at 6 months were associated with clinical outcomes, suggesting that further treatment intensification may be necessary for men with metastatic prostate cancer who fail to achieve undetectable PSA levels after ADT plus enzalutamide.

Key Takeaways:

  • The study found that men with metastatic hormone-sensitive prostate cancer who received enzalutamide plus ADT had improved survival rates when their PSA levels decreased after treatment.
  • The PSA levels at enrollment and the degree of PSA reduction at 6 months were associated with clinical outcomes, including radiographic progression-free survival (rPFS) and overall survival (OS).
  • Further studies are required to further characterize the clinical utility of further treatment intensification among men with mHSPC for whom ADT plus enzalutamide fails to achieve undetectable PSA.
  • The study was conducted on data collected from the ARCHES multinational, double-blind, phase 3 randomized clinical trial, which was performed from March 21, 2016, to January 12, 2018.
  • The study analyzed data from 1,543 patients who were randomized to receive enzalutamide (160 mg/d) plus ADT or placebo plus ADT.
  • The study found that men with PSA levels less than 1 ng/mL at enrollment had improved OS compared to those with PSA levels greater than 1 ng/mL.

Statistics:

  • 1,543 patients were analyzed in the study.
  • 805 patients received enzalutamide plus ADT, while 738 patients received placebo plus ADT.
  • The median follow-up for the entire study was 27.8 months (IQR: 22.5-33.7 months).
  • The median rPFS was 15.1 months (IQR: 11.7-18.9 months) in the enzalutamide plus ADT arm compared to 12.4 months (IQR: 9.8-15.1 months) in the placebo plus ADT arm.
  • The median OS was 42.0 months (IQR: 35.3-50.6 months) in the enzalutamide plus ADT arm compared to 35.1 months (IQR: 28.8-41.9 months) in the placebo plus ADT arm.

Sources:

  • Enzalutamide and Prostate-specific Antigen Levels In Metastatic Prostate Cancer a Secondary Analysis of the Arches Randomized Clinical Trial. JAMA Network Open, 2025;8(5).
  • NewsRx. New Prostate Cancer Findings from Duke Cancer Institute Described (Enzalutamide and Prostate-specific Antigen Levels In Metastatic Prostate Cancer a Secondary Analysis of the Arches Randomized Clinical Trial). Health & Medicine Week. August 8, 2025; p 2978.

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