Editing Biochemical Recurrence (section)

== EMBARK Trial ==

* Population: 1068 patients with high-risk biochemical recurrence (defined as a PSA doubling time of ≤9 months and a PSA level of ≥2 ng per milliliter above nadir after radiation therapy or ≥1 ng per milliliter after radical prostatectomy)
* Randomized to enzalutamide + leuprolide vs. enzalutamide only vs. leuprolide only
* Primary end point: metastasis-free survival in the combination group as compared with the leuprolide-alone group
* Results:
** 5-year metastasis-free survival: absolute risk reduction: 16% (87% combination group vs. 71% leuprolide-alone group, significant); NNT: 6
** 5-year overall survival: absolute risk reduction: 5% (92% combination group vs. 87% leuprolide-alone group, not significant)
**Enzalutamide monotherapy better than leuprolide monotherapy for progression-free survival
***First evidence that second-generation androgen deprivation therapy monotherapy better than first-generation monotherapy
* [https://pubmed.ncbi.nlm.nih.gov/37851874/ Freedland, Stephen J., et al.] "Improved outcomes with enzalutamide in biochemically recurrent prostate cancer." ''New England Journal of Medicine'' 389.16 (2023): 1453-1465.