Why patients should not be advised to take enzalutamide/enzalutamide (Acotan)

Enzalutamide/Enzalutamide ( Enzalutamide) is widely used in the treatment of prostate cancer and is recognized as a representative drug among the new generation of androgen receptor inhibitors, but not all patients are suitable for use. The first thing that needs to be made clear is that drug selection must be based on precision medicine and individualized assessment, rather than relying solely on drug popularity or the experience of others.

The main situations where it is not recommended to take enzalutamide include the following categories. The first category is patients whose indications are not consistent. Enzalutamide is mainly targeted at patients with castration-resistant or castration-sensitive prostate cancer. It has no approved indications for other types of tumors, so its use should not be expanded arbitrarily. The second category is people with serious underlying diseases or special risks, such as those with a history of epilepsy, cerebrovascular disease, or long-term use of drugs that affect the nervous system, because enzalutamide may increase the risk of adverse reactions in the central nervous system. The third category is drug interaction issues. Enzalutamide involves a variety of cytochrome enzyme systems in the metabolism process in the body, and it is easy to interact with anticoagulants, anti-epileptic drugs or certain anti-infective drugs. If not evaluated, the efficacy of the drug may be weakened or side effects may increase.

In addition, in clinical practice, it has also been found that some patients have poor tolerance to the side effects of enzalutamide, such as severe fatigue, decreased appetite, or unstable blood pressure. These conditions may affect treatment compliance if doctors fail to make timely adjustments. For the above reasons, clinicians usually weigh the risks and benefits of enzalutamide based on the patient's overall condition, and not all patients are recommended as the first choice.

Therefore, the so-called "not recommended to take" does not deny the value of the drug. If patients are judged by their doctors to be unsuitable for enzalutamide, they should promptly learn about other options, including abiraterone, chemotherapy drugs, or new drugs in clinical trials, to ensure that they can obtain the most appropriate treatment effect.

Reference materials:https://www.xtandi.com/