Enzalutamide is a potent androgen receptor inhibitor used in combination with androgen deprivation therapy (ADT) for the treatment of metastatic hormone-sensitive prostate cancer (mHSPC). It blocks androgen signaling more completely than ADT alone by preventing testosterone from binding to prostate cancer cells.

Clinical trials (e.g., ARCHES, ENZAMET) have shown that enzalutamide significantly improves overall survival and delays disease progression in men with both low- and high-volume metastatic disease. It is taken as a once-daily oral pill and is often chosen for patients who want to avoid chemotherapy. Common side effects include fatigue, hypertension, falls, and cognitive effects, so patient selection and monitoring are important.