ADT With and Without Xtandi in Men with Metastatic Hormone Sensitive Prostate Cancer: The ARCHES Trial

In a report from the 2019 ASCO Meeting, it was shown that after a median follow-up of 14.4 months men with metastatic hormone sensitive prostate cancer (mHSPC) who were treated with Xtandi (enzalutamide) along with ADT (hormone therapy) had significantly improved radiographic progression-free survival, regardless of their prior treatment.

The analysis was done in a phase III study of 1150 men with metastatic hormone-sensitive prostate cancer (mHSPC).  They were randomized to Xtandi plus ADT or placebo plus ADT. The men were also stratified by disease volume and prior docetaxel (chemotherapy) treatment to determine treatment efficacy. Of these men, 18% had received prior docetaxel, and 91% had received previous ADT or had an orchiectomy. 

After a median follow-up of 14.4 months, the men who had Xtandi along with ADT experienced an improved radiographic progression-free survival advantage over those who had only ADT, regardless of their prior treatment. 

The study also showed that both cohorts of men experienced a similar frequency of grade 3/4 (the most severe) adverse events.

 AJ Armstrong, RZ Szmulewitz, DP Petrylak, et al