Enzalutamide Safety and Efficacy

Adverse Effects

• The American Society of Clinical Oncology notes that fatigue is a common adverse effect of enzalutamide, with a high incidence rate 1, 2
• Hot flushes and diarrhea are also recognized adverse effects of enzalutamide, as reported by the National Comprehensive Cancer Network 1, 2
• Hypertension is a potential adverse effect of enzalutamide, according to the National Comprehensive Cancer Network 3
• Seizures have been reported in 0.6% of patients taking enzalutamide, as noted by the American Society of Clinical Oncology 1, 2

Diagnostic Considerations

• The European Society for Medical Oncology recommends excluding deep vein thrombosis, which would be visible on ultrasound, in patients with leg pain 4
• Skeletal-related events, such as pathologic fracture or bone metastases, can be excluded with MRI, as suggested by the European Society for Medical Oncology 5, 6, 4
• Soft tissue pathology requiring intervention can be assessed with imaging, according to the European Society for Medical Oncology 4

Alternative Explanations for Leg Pain

• Coincidental musculoskeletal pain is a possible explanation for leg pain in patients taking enzalutamide, as noted by the European Society for Medical Oncology 5
• Deconditioning or sarcopenia from androgen deprivation therapy may contribute to leg pain, according to the National Comprehensive Cancer Network 3
• Peripheral vascular disease is a potential cause of leg pain in this age group, as suggested by the European Society for Medical Oncology 4

Survival Benefit

• The American Society of Clinical Oncology reports that enzalutamide provides a substantial mortality benefit, with a 29% reduction in risk of death in chemotherapy-naïve metastatic castration-resistant prostate cancer 7, 8