Possibilities of treatment of patients with castrationrefractory prostate cancer using enzalutamide

Abstract

Prostate cancer is one of the most actual oncourological diseases because of the persisting high rates of morbidity and mortality from this pathology. More than 1 100 000 new cases of this pathology are registered in the world every year. The incidence of prostate cancer in the Russian Federation continues to increase steadily. Despite the success in early detection of this disease, primarily due to the introduction of diagnostics with the use of a specific prostatic antigen, the frequency of detection of primary metastatic cancer of the prostate gland remains high and is about 20%. Metastatic castration-resistant prostate cancer is an extremely heterogeneous disease with an unfavorable prognosis in most of these patients, which requires a differentiated approach when prescribing therapy in each case. Despite the standard approach to prescribing chemotherapy as one of the main methods of drug treatment, the method of hormonal therapy of the second line using drugs aimed at the androgenic mechanism of cellular proliferation regulation is an effective and less toxic option. A fundamentally different mechanism of action has a new drug hormonal therapy of the second line enzalutamide, which is able to selectively block androgen receptors and disturb the translocation of the signal from the receptor into the cell and the cell nucleus. A number of large randomized trials that studied the effectiveness of this drug have allowed to register it for clinical use, including in our country. The article presents a review of the literature on the use of enzalutamide in patients with metastatic castration-refractory prostate cancer, as well as a description of the clinical case of the use of this drug in real practice.