Enzalutamide may not be contraindicated for mCRPC patients with seizure risk factors
medwireNews: In men with metastatic castration-resistant prostate cancer (mCRPC) and seizure risk factors, treatment with enzalutamide does not increase the incidence of seizures, shows the UPWARD safety study.
Seizures are a class effect of androgen receptor antagonists, explain the investigators who enrolled 366 patients with one or more predisposing factors, including medications that lower the seizure threshold and a history of stroke or seizure.
As reported in JAMA Oncology, four men had at least one seizure within 4 months of initiating enzalutamide 160 mg/day and a further three had a seizure in the subsequent 4-month period. This gave an incidence of 2.6 cases per 100 person–years, which was comparable to the 2.8 cases per 100 person–years incidence previously observed among mCRPC patients with seizure risk factors who were not exposed to enzalutamide.
Lead author Susan Slovin (Memorial Sloan Kettering Cancer Center, New York, USA) and team conclude: “The risk profile presented, along with the previously established efficacy of enzalutamide, suggests that enzalutamide can benefit patients with a history of seizures or other predisposing factors, but each patient should be closely monitored for the duration of treatment.”
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