Over the past few years we’ve learned early intensification of ADT with either another androgen-targeted agent or docetaxel improves survival for men with metastatic castrate-sensitive prostate cancer (mCSPC). And when it comes to androgen receptor blockers, next-gen agents like enzalutamide, outperform first-gen agents like bicalutamide. Is this the case for Black men? Fair question since landmark trials like ENZAMET failed to enroll even one Black man. This prospective phase 2 trial  was designed to assess racial differences in efficacy of enzalutamide versus bicalutamide in addition to ADT for mCSPC. Among the 42 non-Black men, the primary endpoint of PSA response at 7 months was not different with enzalutamide (94%) versus bicalutamide (86%). That was in stark contrast to the significant improvement among the 29 Black men with enzalutamide (93%) versus bicalutamide (42%). TBL: “Racial differences in bicalutamide efficacy are overcome by using contemporary [agents] such as enzalutamide in advanced prostate cancer. | Vaishampayan, JAMA Netw Open 2021


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