The Design and Results of the PREVAIL Trial

Tomasz Beer, MD, FACP, professor of medicine, deputy director of the Knight Cancer Institute, Oregon Health and Science University, discusses the design and results of the PREVAIL trail, which evaluated enzalutamide in men with chemotherapy-naïve metastatic prostate cancer.

Clinical Pearls:

• Enzalutamide is an androgen receptor inhibitor and has previously been shown to improve overall survival and progression-free survival in patients with prostate cancer who had more advanced disease and were treated with chemotherapy
• In the PREVAIL trial, 1717 patients were randomized to either placebo or enzalutamide across 207 sites worldwide
• Results showed an 81% reduction in the risk of radiographic progression
• Median time to progression was 3.9 months in placebo but has not been reached in the enzalutamide-treated patients
• There was a 29% improvement in overall survival and there was a 17-month delay in the need for cytotoxic chemotherapy
• The drug was well tolerated and there were delays in PSA progression and quality of life deterioration