Enzalutamide Plus ADT Shows Prognostic Benefit Tied to PSA Response in mHSPC

In this secondary analysis of the ARCHES phase 3 trial with 1,150 men, enzalutamide added to androgen deprivation therapy (ADT) improved radiographic progression-free and overall survival across PSA subgroups. Patients who achieved undetectable PSA levels (<0.2 ng/mL) experienced an 86% reduction in progression risk and a 76% reduction in death risk compared to placebo plus ADT.

The marked survival benefit linked to achieving an undetectable PSA highlights the potential of PSA response as a key marker for guiding further treatment intensification in metastatic hormone-sensitive prostate cancer.