Luncheon Symposium 22【Astellas】

This presentation highlights the clinical value of integrating enzalutamide in the treatment of patients with metastatic and non-metastatic castration-sensitive prostate cancer (mCSPC and nmCSPC). For mCSPC, patients often face a poor prognosis and declining quality of life as the disease progresses. Clinical studies, such as the ARCHES trial, have demonstrated that combining enzalutamide with androgen deprivation therapy significantly improves overall survival and delays disease progression. Enzalutamide’s favorable safety profile, especially when compared to chemotherapy, supports its use in maintaining patients’ daily function and quality of life. As such, guidelines increasingly recommend including enzalutamide in the initial treatment strategy for mCSPC to optimize long-term outcomes.

In parallel, for patients with high-risk biochemical recurrence (BCR) in non-metastatic castration-sensitive prostate cancer (nmCSPC), early intervention is equally critical. These patients are at elevated risk of progressing to metastatic disease. The EMBARK trial provides strong evidence that early treatment intensification with enzalutamide can significantly prolong metastasis-free survival (MFS) and delay disease progression. These results underscore the importance of initiating treatment while disease burden is still low. Clinicians are encouraged to proactively identify high-risk BCR patients and adopt early intensified treatment strategies to improve outcomes. Together, the evidence from both mCSPC and nmCSPC supports the timely and strategic use of enzalutamide in castration-sensitive settings.