Active surveillance versus enzalutamide for low‐risk prostate cancer – was it really a trial we needed?

Abbreviations AS active surveillance NCCN National Comprehensive Cancer Network The management of low-risk prostate cancer in North America has recently seen some unexpected, surprising, and somewhat perplexing occurrences. Examples include recent imaging trials using prostate-specific membrane antigen positron emission tomography-CT to better target and provide more informed initial biopsy as found in the PRIMARY trial [4], or CONFIRM trial (Australian New Zealand Clinical Trials Registry [ACTRN]12621001648819 at https://www.anzctr.org.au) aiming to better select men for AS prior to confirmatory biopsy. This trial concluded that 'enzalutamide monotherapy was well-tolerated and demonstrated a significant treatment response in patients with low-risk or intermediate-risk localized prostate cancer', and that 'enzalutamide may provide an alternative treatment option for patients undergoing AS'. [Extracted from the article]