To the Editor:
Pain treatment in patients with bone-metastasized advanced prostate cancer is often challenging. A range of treatment modalities are available to control prostate cancerespecific pain, such as androgen deprivation therapies, taxane-based chemotherapy, radionuclide therapy with radium-223, or palliative radiotherapy. In addition, analgesics are commonly used for direct symptom management.

We describe three cases which show difficulties of pain management in enzalutamide-treated patients with metastatic bone disease due to castrationresistant prostate cancer (CRPC). The potential illustrations of drug-drug interactions noted in these cases are of important clinical relevance. [...]