enzalutamide + leuprolide

Enzalutamide + leuprolide is a pharmaceutical combination used for the treatment of nonmetastatic, castration-sensitive prostate cancer with high-risk biochemical recurrence (nmHSPC with BCR at high risk for metastasis). Enzalutamide is a second-generation androgen receptor inhibitor (small molecule, nonsteroidal antiandrogen) that impairs androgen receptor nuclear translocation, DNA binding, and coactivator recruitment, thereby inhibiting androgen signaling in prostate cancer cells. Leuprolide is a synthetic gonadotropin-releasing hormone (GnRH) agonist that initially stimulates, then suppresses, pituitary luteinizing hormone release, leading to medical castration (suppressed testosterone). The combination targets androgen receptor signaling and systemic androgen deprivation, resulting in improved metastasis-free survival and overall survival compared to leuprolide alone in high-risk prostate cancer. The combination is FDA-approved for adult patients with nonmetastatic, hormone-sensitive prostate cancer at high risk for metastasis following biochemical recurrence after previous definitive therapy. Clinical development and marketing were led by Astellas Pharma and Pfizer, the originators and manufacturers of enzalutamide; leuprolide is widely available from several manufacturers, but within this combination, it is typically provided as leuprolide acetate injection[1][2][3][4][5][6][7].