Investig Clin Urol.  2020 Jan;61(1):19-27. 10.4111/icu.2020.61.1.19.

Enzalutamide in chemotherapy-naive patients with metastatic castration-resistant prostate cancer: A retrospective Korean multicenter study in a real-world setting

  • 1Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
  • 2Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 4Department of Urology, Korea University College of Medicine, Seoul, Korea.
  • 5Department of Urology, Center for Prostate Cancer, Korea National Cancer Center, Goyang, Korea.
  • 6Department of Urology, Severance Hospital, Yonsei University Health System, Seoul, Korea.
  • 7Department of Urology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 8Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
  • 9Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 10Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 11Department of Urology, The Catholic University of Korea, Seoul St. Mary Hospital's, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 12Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 13Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.


This study aimed to evaluate the clinical efficacy of enzalutamide in chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC) patients using real-world data from Korean patients.
We retrospectively reviewed the medical records of 199 chemotherapy-naïve patients with mCRPC at 13 tertiary centers in Korea between 2014 and 2017. All patients received enzalutamide daily and 89 patients received concurrent androgen deprivation therapy (ADT).
The median age of the patients was 74 years. Initial results showed that 81.5% of the patients had Gleason score ≥8 and 33.3% of the patients had European Cooperative Oncology Group Performance Status 0. The overall mortality rate was 12%. The median OS was not archieved and 76.7% of patients were alive at 30 months. Median time until PSA progression was 6 months. The overall survival rate at 2 years was significantly higher (84.6% vs. 71.7%, p=0.015) and the duration of PSA progression-free survival was significantly longer (8.0 vs. 4.6 months, p=0.008) in patients receiving concurrent ADT than in those receiving enzalutamide alone. The incidence of adverse events of grade 3 or higher was 1.7%. Multivariate Cox proportional hazard analysis indicated that ADT administered concurrently with enzalutamide significantly improved the overall survival (hazard ratio, 0.346; 95% confidence interval, 0.125-0.958).
Enzalutamide is effective and safe for chemotherapy-naïve patients with mCRPC. Furthermore, the overall survival was significantly higher in patients receiving enzalutamide and concurrent ADT than in patients receiving enzalutamide alone.


Androgen antagonists; Neoplasm metastasis; Prostate neoplasms; Treatment outcome

MeSH Terms

Androgen Antagonists
Disease-Free Survival
Medical Records
Neoplasm Grading
Neoplasm Metastasis
Prostatic Neoplasms*
Retrospective Studies*
Survival Rate
Treatment Outcome
Androgen Antagonists
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