Back in 2019, the ARCHES trial made waves when it showed that combining enzalutamide, an androgen receptor pathway inhibitor, with androgen deprivation therapy (ADT) slashed the risk of cancer progression by over 60% in metastatic hormone-sensitive prostate cancer (mHSPC) patients. Published in the Journal of Clinical Oncology, these results from over 1,150 men worldwide led to the FDA approving the regimen. The trial’s focus was radiographic progression-free survival—how long it takes for cancer to visibly worsen on scans.

By 2021, updated data revealed even bigger news: the treatment didn’t just delay progression but boosted overall survival by about 30%.

Fast forward to 2025, and the ARCHES trial’s five-year follow-up data is turning heads again. With every patient tracked for at least five years, the study confirms that enzalutamide plus ADT extends survival by 30%, meaning 13% more men are alive at the five-year mark compared to those on ADT alone.

This benefit holds across all kinds of patients, whether their cancer is high- or low-volume, regardless of age, location, or prior treatments. Survival improvements range from 9% to 17%, but the real big deal is for men with high-volume disease, where cancer has spread widely.
Their median survival jumped from four years to seven,an extra three years to spend with family, free from the worst symptoms and the need for harsher treatments like chemotherapy.

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