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Safety and efficacy of reduced dose of enzalutamide in patients with castration-resistant prostate cancer: a systematic review

Belabaci, Z.
; 
Mose, L.
; 
El-Taji, O.
; 
Otmani, Z.
; 
Hannouneh, Z. A.
; 
Mohamad, I.
; 
Zilli, T.
; 
Mohamad, O.
; 
Pervez, N.
; 
Arafat, W.
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Abstract
Objective: To review the efficacy and safety of reduced dose compared to standard dose Enzalutamide treatment for patients with castration-resistant prostate cancer (CRPC). Methods: PubMed, Scopus, Web of Science, and Cochrane databases were searched for randomized controlled trials and cohort studies reporting the use of Enzalutamide in reduced and standard doses in patients with castration-resistant prostate cancer. Searches were limited to articles published in the English language. Outcome assessments included progression-free survival (PFS), overall survival (OS), adverse events, and serum prostate-specific antigen (PSA) response. Results: Ten studies met the inclusion criteria, including 2481 patients treated with Enzalutamide. Seven studies were retrospective cohorts, two were prospective trials, and one was a prospective cohort. No consistent relationship was identified between OS and PFS and the Enzalutamide dosage. Reduced doses of Enzalutamide decreased the incidence of adverse events, particularly among elderly patients. Conclusions: This systematic review suggests that reduced doses of Enzalutamide in CRPC may maintain therapeutic efficacy in selected patients while improving tolerability. However, inconsistent findings and methodological limitations highlight the need for prospective randomized trials to define optimal and individualized dosing strategies.
Authors
Belabaci, Z.
Mose, L.
El-Taji, O.
Otmani, Z.
Hannouneh, Z. A.
Mohamad, I.
Zilli, T.
Mohamad, O.
Pervez, N.
Arafat, W.
Vogl, U.
Shelan, M.
Affiliation
Faculty of Medicine, Djillali Liabes University, Sidi Bel Abbes 22000, Algeria. Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland. Genitourinary Cancer Research Group, University of Manchester, The Christie & Salford NHS Foundation Trust, Manchester M20 4BX, UK. Faculty of Medicine, Mouloud Mammeri University, Tizi Ouzou 15000, Algeria. Faculty of Medicine, Al Andalus University for Medical Sciences, Tartus 37444, Syria. Department of Radiation Oncology, King Hussein Cancer Center, Amman 11941, Jordan. Department of Radiation Oncology, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland. Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland. Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland. Department of Genito-Urinary Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, USA. Department of Internal Medicine, College of Medicine and Health Sciences (CMHS), UAE University, Abu Dhabi P.O. Box 15551, United Arab Emirates. Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt. Department of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, 6500 Bellinzona, Switzerland.
Description
Date
2025
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All Christie Publications
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Systematic Review
Citation
Belabaci Z, Mose L, El-Taji O, Otmani Z, Hannouneh ZA, Mohamad I, et al. Safety and Efficacy of Reduced Dose of Enzalutamide in Patients with Castration-Resistant Prostate Cancer: A Systematic Review. Pharmaceuticals (Basel, Switzerland). 2025 May 16;18(5). PubMed PMID: 40430550. Pubmed Central PMCID: PMC12114795. Epub 2025/05/28. eng.
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https://christie.openrepository.com/handle/10541/628092
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