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Given recent evidence that the second-generation androgen-receptor inhibitor enzalutamide improves survival in men with metastatic castration-resistant prostate cancer (CRPC; e.g., NEJM JW Oncol Hematol March 2016, and Lancet Oncol 2016; 17:153), investigators conducted an industry-sponsored, randomized, double-blind, phase II trial comparing enzalutamide (160 mg/day) with standard bicalutamide (50 mg/day) in 396 men with either metastatic (257) or nonmetastatic (139) CRPC. The primary endpoint was progression-free survival (PFS) using composite events that included prostate-specific antigen progression and radiographic progression.
The median duration of treatment was 14.7 months with enzalutamide and 8.4 months with bicalutamide. At median…