Enzalutamide (enzalutamide), an oral androgen receptor antagonist, is used in the treatment of metastatic desmoid-resistant prostate cancer that has progressed after chemotherapy and may prolong patient survival. However, there is currently a lack of new treatments for patients with metastatic prostate cancer who have not received chemotherapy after failure of trans-androgenic blockade therapy. To this end, Professor Beer of the Knight Cancer Institute at Oregon Health & Science University conducted a randomized, double-blind phase 3 trial, published online in the July 31, 2014 issue of NEJM. 1717 patients were randomized to the enzalutamide and placebo groups and received either 160 mg enzalutamide or placebo daily. The composite endpoints were progression-free survival on imaging and overall survival. At 12 months, the progression-free survival rate was 65% in the enzalutamide group and 14% in the placebo group. At the time of data collection termination, 626 (72%) were alive in the enzalutamide group and 532 (63%) were alive in the placebo group. Enzalutamide also demonstrated a treatment advantage in each of the secondary endpoints, including: time to cytotoxic chemotherapy initiation, time to first bone-related event, complete or partial soft tissue response, time to prostate-specific antigen (PSA) elevation, and the proportion of PSA decreases ≥50%. The main drug-related adverse events in the enzalutamide group were hypertension and fatigue. In summary, enzalutamide was effective in reducing the risk of progression and death in metastatic prostate cancer and delaying the initiation of chemotherapy in patients.