Effects of Enzalutamide on the Sexual Activity of Patients with Biochemically Recurrent Prostate Cancer: A Post Hoc Analysis of Patient-reported Outcomes in the EMBARK Study

作者：Stephen J. Freedland, John P. Mulhall, Martin Gleave, Ugo De Giorgi, Fred Saad, Antti Rannikko, Jasmina Ivanova, Anchen F. Nasr, Arlene Reisman, Arijit Ganguli, Pavol Kráľ, James Turnbull, Neal D. Shore · 发表于：European Urology · 年份：2025 · DOI：10.1016/j.eururo.2025.02.006 · 被引用次数：12 · 研究领域：Prostate Cancer Treatment and Research、Prostate Cancer Diagnosis and Treatment、Hormonal and reproductive studies

A post hoc analysis for the EMBARK trial showed better maintenance of sexual activity—interest, activity, satisfaction, and erectile function—with enzalutamide monotherapy than with leuprolide alone. For patients who were interested in sex or were sexually active before starting treatment, enzalutamide monotherapy was more effective in preserving sexual activity than leuprolide alone. EMBARK demonstrated prolonged metastasis-free survival with enzalutamide ± leuprolide versus leuprolide alone for patients with high-risk biochemical recurrence of prostate cancer, with health-related quality of life (HRQoL) maintained. To evaluate treatment effects on sexual activity (SA), item-level analyses of SA-related HRQoL were performed. HRQoL was assessed (baseline, every 12 wk) until metastasis or death. Time to confirmed clinically meaningful deterioration (TTCD; confirmed at next visit) and longitudinal changes in HRQoL were examined using Cox regression and mixed-model repeated measures analyses, respectively. In comparison to leuprolide alone, enzalutamide monotherapy delayed TTCD in interest in sex (8.5 vs 5.6 mo; hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.57–0.87; p < 0.001), extent of SA (5.7 vs 3.0 mo; HR 0.69, 95% CI 0.54–0.90; p = 0.004), satisfaction with sex life (11.1 vs 5.4 mo; HR 0.61, 95% CI 0.45–0.84; p = 0.001), and erectile function (5.5 vs 2.9 mo; HR 0.67, 95% CI 0.50–0.88; p = 0.003). TTCD in SA-related HRQoL was similar with enzalutamide + leuprolide a...