Belabaci Zineddine, Mose Lucas, El-Taji Omar, Otmani Zina, Hannouneh Zein Alabdin, Mohamad Issa, Zilli Thomas, Mohamad Osama, Pervez Nadeem, Arafat Waleed, Vogl Ursula, Shelan Mohamed
Faculty of Medicine, Djillali Liabes University, Sidi Bel Abbes 22000, Algeria.
Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Pharmaceuticals (Basel). 2025 May 16;18(5):732. doi: 10.3390/ph18050732.
To review the efficacy and safety of reduced dose compared to standard dose Enzalutamide treatment for patients with castration-resistant prostate cancer (CRPC). PubMed, Scopus, Web of Science, and Cochrane databases were searched for randomized controlled trials and cohort studies reporting the use of Enzalutamide in reduced and standard doses in patients with castration-resistant prostate cancer. Searches were limited to articles published in the English language. Outcome assessments included progression-free survival (PFS), overall survival (OS), adverse events, and serum prostate-specific antigen (PSA) response. Ten studies met the inclusion criteria, including 2481 patients treated with Enzalutamide. Seven studies were retrospective cohorts, two were prospective trials, and one was a prospective cohort. No consistent relationship was identified between OS and PFS and the Enzalutamide dosage. Reduced doses of Enzalutamide decreased the incidence of adverse events, particularly among elderly patients. This systematic review suggests that reduced doses of Enzalutamide in CRPC may maintain therapeutic efficacy in selected patients while improving tolerability. However, inconsistent findings and methodological limitations highlight the need for prospective randomized trials to define optimal and individualized dosing strategies.
回顾与标准剂量恩杂鲁胺治疗相比，降低剂量恩杂鲁胺治疗去势抵抗性前列腺癌（CRPC）患者的疗效和安全性。检索了PubMed、Scopus、Web of Science和Cochrane数据库，以查找报告在去势抵抗性前列腺癌患者中使用降低剂量和标准剂量恩杂鲁胺的随机对照试验和队列研究。检索仅限于以英文发表的文章。结局评估包括无进展生存期（PFS）、总生存期（OS）、不良事件和血清前列腺特异性抗原（PSA）反应。10项研究符合纳入标准，包括2481例接受恩杂鲁胺治疗的患者。7项研究为回顾性队列研究，2项为前瞻性试验，1项为前瞻性队列研究。未发现OS、PFS与恩杂鲁胺剂量之间存在一致关系。降低剂量的恩杂鲁胺可降低不良事件的发生率，尤其是在老年患者中。该系统评价表明，在CRPC患者中降低剂量的恩杂鲁胺可能在选定患者中维持治疗效果，同时提高耐受性。然而，研究结果不一致和方法学局限性凸显了进行前瞻性随机试验以确定最佳和个体化给药策略的必要性。
