Efficacy and Safety Results from a Phase 2, Randomized, Double-Blind Study of Enzalutamide Versus Placebo in Advanced Hepatocellular Carcinoma.

Baek-Yeol Ryoo, Daniel H Palmer, Sook Ryun Park, Lorenza Rimassa, Bruno Daniele, Joyce Steinberg, Beatriz López, Ho Yeong Lim

Journal: Clinical drug investigation 2021;41(9):795-808

PMID: 34351608

Abstract

BACKGROUND AND OBJECTIVE

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related mortality worldwide. Despite recent advances, more effective therapeutic options for patients with advanced HCC are still required. The aim of this Phase 2, multicenter, multinational, randomized, double-blind, placebo-controlled study (NCT02528643) was to investigate the potential benefit of enzalutamide in the treatment of patients with advanced HCC.

METHODS

Patients aged ≥ 18 years diagnosed with advanced HCC (Barcelona Clinic Liver Cancer stage B or C and Child-Pugh class A at screening who had progressed on, or were intolerant to, sorafenib or other anti-vascular endothelial growth factor therapies) were randomized 2:1 to receive either enzalutamide 160 mg daily or placebo. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS) and safety.

RESULTS

In total, 165 patients were randomized to enzalutamide (n = 110) or placebo (n = 55). The hazard ratio (HR) (95% confidence interval [CI]) for OS was 1.15 (0.774-1.696) and median OS was 7.8 months and 7.7 months for enzalutamide and placebo, respectively. The HR (95% CI) for PFS was 1.04 (0.732-1.474) and median PFS was 2.2 months and 1.9 months for enzalutamide and placebo, respectively. The overall frequency of treatment-emergent adverse events (TEAEs) was broadly similar between the groups: 105 (98.1%) enzalutamide patients experienced ≥1 TEAEs compared with 49 (89.1%) placebo patients.

CONCLUSIONS

The results of this study indicate that enzalutamide does not provide a benefit in patients with advanced HCC. No unexpected safety findings were observed in the trial. CLINICALTRIALS.

GOV IDENTIFIER

NCT02528643.

© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Address: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. [email protected].; Liverpool CR UK/NIHR Experimental Cancer Medicine Centre, and The Clatterbridge Cancer Centre, Liverpool, UK.; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.; School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.; Department of Oncology, G. Rummo Hospital, Benevento, Italy.; Oncology Unit, Ospedale del Mare, Naples, Italy.; Astellas Pharma Inc., Northbrook, IL, USA.; Data Science, Astellas Pharma Inc., Leiden, The Netherlands.; Quantitative Sciences, Janssen R&D, Janssen Pharmaceutical Companies of Johnson & Johnson, Leiden, The Netherlands.; Division of Hematology-OncologyDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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