A Dose Optimization Study of Enzalutamide in Elderly Patients With Advanced Prostate Cancer

Enzalutamide is an androgen receptor pathway inhibitor (ARPI) drug that is commonly used in prostate cancer. It is safe, effective, and is generally well tolerated by patients at the standard dose of 160mg, however researchers have seen that it may cause unfavorable side effects in elderly patients 75 and older such as fatigue and cognitive impairment that impact their quality of life more significantly than those under 75. To date there is limited research comparing differences in side effects and quality of life experienced by elderly patients on standard versus a lower dose of enzalutamide. Dose reductions are common, particularly in elderly patients, although they are not explicitly recommended on the drug label, and as a result this study seeks to build on the existing research and practice experience to evaluate how enzalutamide is metabolized in elderly patients and whether this difference warrants different dosing standards in these patients.