HSD3B1 Genotype and Outcomes in Metastatic Prostate Cancer
Practical Solutions and Value Highlights
HSD3B1 genotype plays a role in metastatic hormone-sensitive prostate cancer (mHSPC) outcomes. The AP allele is linked to castration resistance, particularly in low-volume tumors, affecting post-progression mortality and treatment-emergent adverse events.
Enzalutamide plus androgen deprivation therapy (ADT) in men with mHSPC showed clinical benefit in a phase 3 trial. Enzalutamide significantly improves radiographic progression-free survival and overall survival vs. placebo regardless of HSD3B1 status.
Despite differences in adverse events based on genotype, enzalutamide is beneficial for men with mHSPC independent of HSD3B1 genotype. Inherited polymorphisms of HSD3B1 may explain variable toxicities.
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