{"entity":{"id":"paper-prosper-nejm-2018","kind":"paper","name":"PROSPER: enzalutamide in men with non-metastatic castration-resistant prostate cancer","aka":[],"tldr":"Enzalutamide delayed metastases by almost two years in men with rapidly rising PSA on hormone therapy and no visible spread, and longer follow-up showed it also lengthened survival.","summary":"Phase 3 placebo-controlled trial of 1,401 men with non-metastatic castration-resistant prostate cancer and PSA doubling time of ten months or less randomised 2:1 to enzalutamide or placebo with continued androgen deprivation.\n\nMedian metastasis-free survival was 36.6 versus 14.7 months (hazard ratio 0.29), and the final analysis showed median overall survival of 67.0 versus 56.3 months (hazard ratio 0.73); fatigue, hypertension and falls were more common.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2018","url":"https://doi.org/10.1056/NEJMoa1800536"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29949494/"}],"tags":[],"related":[],"cancers":["prostate-nmcrpc"],"sections":[],"technologies":[],"targets":[],"drugs":["enzalutamide"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["prosper"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2018,"doi":"10.1056/NEJMoa1800536","pmid":"29949494","authors":"Hussain M, Fizazi K, Saad F, et al.","paperType":"rct","findings":["Median metastasis-free survival 36.6 vs 14.7 months; hazard ratio 0.29.","Median overall survival 67.0 vs 56.3 months; hazard ratio 0.73."],"whatItMeans":"Enzalutamide is one of three androgen receptor inhibitors standard for high-risk non-metastatic castration-resistant prostate cancer.","caveats":["Fatigue and cognitive effects are more prominent than with darolutamide.","Conventional imaging defined non-metastatic status."],"changedPractice":true,"participants":1401},"route":"/key-papers/paper-prosper-nejm-2018/","neighbours":{"cancer":[{"id":"prostate-nmcrpc","kind":"cancer","name":"Non-metastatic castration-resistant prostate cancer","route":"/cancers/prostate-nmcrpc/"}],"drug":[{"id":"enzalutamide","kind":"drug","name":"Enzalutamide","route":"/drugs/enzalutamide/"}],"trial":[{"id":"prosper","kind":"trial","name":"PROSPER","route":"/trials/prosper/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}