INTRODUCTION: Prostate cancer is one of the most common cancers in men. Despite the sharp rise in incidence, mortality is decreasing. ARTA preparations are preferred options for asymptomatic or mildly symptomatic patients with mCRPC. The use of enzalutamide in elderly patients with mCRPC is risky and depends on a number of factors. An increased risk of falls and fractures has been shown. CASE PRESENTATION: We present a case report of an elderly patient with mCRPC treated with enzalutamide with very good long-term tolerance and efficacy. CONCLUSION: Despite the older age, no reduction of therapy was necessary in the patient due to good tolerance. Administration of enzalutamide in full doses resulted in a very good effect of therapy.

Faculty of Medicine Masaryk University Brno Czech Republic

Masaryk Memorial Cancer Institute Brno Czech Republic

See more in PubMed

Tran C, Ouk S, Clegg NJ, Chen Y, Watson PA, Arora V, et al. . Development of a second-generation antiandrogen for treatment of advanced prostate cancer. Science. 2009;324(5928):787–90. PubMed PMC

Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, et al. . Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(13):1187–97. PubMed

Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. . Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(5):424–33. PubMed PMC

Shore ND, Chowdhury S, Villers A, Klotz L, Siemens DR, Phung D, et al. . Efficacy and safety of enzalutamide versus bicalutamide for patients with metastatic prostate cancer (TERRAIN): a randomised, double-blind, phase 2 study. Lancet Oncol. 2016;17:153–63. PubMed

Iacovelli R, Ciccarese C, Bria E, Romano M, Fantinel E, Bimbatti D, et al. . The cardiovascular toxicity of abiraterone and enzalutamide in prostate cancer. Clin Genitourin Cancer. 2018;16(3):e645–53. PubMed

Taitt HE. Global trends and prostate cancer: a review of incidence, detection, and mortality as influenced by race, ethnicity, and geographic location. Am J Mens Health. 2018;12(6):1807–23. PubMed PMC

Tagawa ST, Ramaswamy K, Huang A, Mardekian J, Schultz NM, Wang L, et al. . Survival outcomes in patients with chemotherapy-naive metastatic castration-resistant prostate cancer treated with enzalutamide or abiraterone acetate. Prostate Cancer Prostatic Dis. 2021;24(4):1032–40. PubMed PMC

Scailteux LM, Campillo-Gimenez B, Kerbrat S, Despas F, Mathieu R, Vincendeau S, et al. . Overall survival among chemotherapy-naive patients with castration-resistant prostate cancer under abiraterone versus enzalutamide: a direct comparison based on a 2014–2018 French population study (the SPEAR cohort). Am J Epidemiol. 2021;190(3):413–22. PubMed

Lee HY, Chen HL, Teoh JYC, Chen TC, Hao SY, Tsai HY, et al. . Abiraterone and enzalutamide had different adverse effects on the cardiovascular system: a systematic review with pairwise and network meta-analyses. Prostate Cancer Prostatic Dis. 2021;24(1):244–52. PubMed

Schultz NM, Penson DF, Wilson SD, Song Y, Yang H, Ramaswamy K, et al. . Health care resource utilization and costs associated with corticosteroid use in patients with castration-resistant prostate cancer: an administrative Claims analysis. J Manag Care Spec Pharm. 2019;25(8):889–97. PubMed PMC

Mollica V, Rizzo A, Rosellini M, Marchetti A, Ricci AD, Cimadamore A, et al. . Bone targeting agents in patients with metastatic prostate cancer: state of the art. Cancers. 2021;13(3):546. PubMed PMC

Vinh-Hung V, Natchagande G, Joachim C, Gorobets O, Drame M, Bougas S, et al. . Low-dose enzalutamide in late-elderly patients (≥75 years old) presenting with metastatic castration-resistant prostate cancer. Clin Genitourin Cancer. 2020;18(6):e660–8. PubMed

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33. PubMed

Riaz IB, Islam M, Ikram W, Naqvi SAA, Maqsood H, Saleem Y, et al. . Disparities in the inclusion of racial and ethnic minority groups and older adults in prostate cancer clinical trials: a meta-analysis. JAMA Oncol. 2023;9(2):180–7. PubMed PMC

Sedrak MS, Gilmore NJ, Carroll JE, Muss HB, Cohen HJ, Dale W. Measuring biologic resilience in older cancer survivors. J Clin Oncol. 2021;39(19):2079–89. PubMed PMC

Rosellini M, Santoni M, Mollica V, Rizzo A, Cimadamore A, Scarpelli M, et al. . Treating prostate cancer by antibody-drug conjugates. Int J Mol Sci. 2021;22(4):1551. PubMed PMC

Rizzo A, Santoni M, Mollica V, Fiorentino M, Brandi G, Massari F. Microbiota and prostate cancer. Semin Cancer Biol. 2022;86(Pt 3):1058–65. PubMed

Lythgoe M, Dama P, Frampton AE, Pickford E, Tookman L, Cunnea P, et al. . Immune modulation and the oral live biotherapeutic product, MRx0518, in treatment-naïve patients with cancer: updated safety data. J Clin Orthod. 2023;41(16_Suppl):3145.

Che B, Zhang W, Li W, Tang K, Yin J, Liu M, et al. . Bacterial lipopolysaccharide-related genes are involved in the invasion and recurrence of prostate cancer and are related to immune escape based on bioinformatics analysis. Front Oncol. 2023;13:1141191. PubMed PMC