# ARCHES 5-year Survival with Enzalutamide Plus Androgen-deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer Patients

Source: https://onco.cc/key-papers/paper-arches-eur-urol-2026-update/  
OnCo record `paper-arches-eur-urol-2026-update` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Later report from the ARCHES trial registered as NCT02677896, in European Urology (2026); its title describes an updated or longer-term analysis.

## Summary

The ARCHES trial (NCT02677896) showed improved radiographic progression-free survival (primary analysis; 2018) and overall survival (prespecified analysis; 2021) with enzalutamide versus placebo, with concomitant androgen-deprivation therapy, in metastatic hormone-sensitive prostate cancer (mHSPC) patients. This post hoc analysis describes 5-yr efficacy and safety for all 1150 randomized patients (data cutoff: July 31, 2024). Patients were randomized 1:1 to receive enzalutamide or placebo (first patient randomized: March 21, 2016). After the primary analysis, ARCHES was unblinded (December 10, 2018); 65% and 32% of patients in the enzalutamide and placebo groups, respectively, enrolled in the open-label extension. After the 61.4-mo median follow-up, 5-yr survival probability was 66% with enzalutamide and 53% with placebo (median months not reached in either group; hazard ratio [HR]: 0.70; 95% confidence interval [CI]: 0.58, 0.85; p < 0.001; adjusted HR: 0.64; 95% CI: 0.51, 0.75). Patients with high-volume disease who received enzalutamide lived 36 mo longer than those who received placebo (HR: 0.70; 95% CI: 0.56, 0.88). No new safety signals emerged. As this was a post hoc, non-alpha protected analysis, the overall survival p value is nominal and should be interpreted cautiously. Overall, this study provides compelling long-term data demonstrating survival benefits with enzalutamide across diverse patient subgroups to guide clinical decision-making and establish prognostic expectations in the mHSPC setting.

Indexed on Europe PMC as PubMed record 41633900 (DOI 10.1016/j.eururo.2025.12.021). Its abstract cites the registry id NCT02677896, which is how it was matched to this trial; no figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: European Urology
- Year: 2026
- DOI: 10.1016/j.eururo.2025.12.021
- Authors: Armstrong AJ, Petrylak DP, Shore ND, et al.
- What it means: A second publication from the ARCHES trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.
- Caveats: Matched to the trial by the registry id cited in the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.; Chosen as a later report by words in its title (updated, long-term, final, overall survival or a year count), not by reading the paper.

## Sources

- Eur Urol 2026: https://doi.org/10.1016/j.eururo.2025.12.021
- PubMed: https://pubmed.ncbi.nlm.nih.gov/41633900/
- Europe PMC: https://europepmc.org/article/MED/41633900
- ClinicalTrials.gov NCT02677896: https://clinicaltrials.gov/study/NCT02677896

## Connected records

- trials: [ARCHES](https://onco.cc/trials/arches/)
- journals: [European Urology](https://onco.cc/journals/european-urology/)

---
JSON: https://onco.cc/api/v1/entities/paper-arches-eur-urol-2026-update.json