Pharmacokinetics:
According to a research conducted by Rodriguez-Vida et al. the pharmacokinetics of Enzalutamide can be understood. What they did was that the chose healthy male volunteers and few metastatic CRPC containing patients and tested the pharmacokinetic profile of enzalutamide and N-desmethyl-enzalutamide which is one of the primary metabolite of enzalutamide. When 30-60 mg of the drug was given orally the first order absorption was seen and it was found that the drug absorbed rapidly. The time it took to reach it peak plasma conc. was from 30-240 minutes. The t1/2 was found to be 7 days and the dose did not hamper the half-life. Steady plasma conc. of the drug was established after 30 days and very little fluctuation was observed. Enzalutaime bonded 97-98% to plasma proteins. (Rodriguez-Vida, Chowdhury, Sternberg, Rudman & Galazi, 2018)
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Androgen deprivation combined with immune-based treatments- clinical trials for prostate cancer:
It was the year 2013 when the revolution in the field of cancer immunotherapy was made possible and it has been possible because of the achievements of T-cell checkpoint inhibitors for the purpose of treating multiple types of cancers. It has been found that these agents offer very narrow range of activity when used as monotherapies for prostate cancer. In 2010 in the treatment of advanced, metastatic CRPC the anti-tumor vaccine Sipuleucel-T was commissioned. Rilimogenegalvacireovec/rilimogeneglafolivec is in phase 3 of clinical trial at present. (Gamat & McNeel, 2017)
Since the ADTs can give immunomodulatory effects they are judiciously being combined with the immunotherapies. Having said that, the combination therapies still remain to be a challenge for the researchers to undergo exploration. (Gamat & McNeel, 2017)
Now let’s see some examples of combination therapies of immunotherapeutic agents and ADT. The table below can give us some ideas regarding it.