Assessing the Role of Darolutamide in CRPC

Raoul S. Concepcion, MD, FACS, director, Comprehensive Prostate Center, discusses takeaways from the ARAMIS study of darolutamide in patients with nonmetastatic castration-resistant prostate cancer (CRPC).

Darolutamide is structurally different from the 2 FDA-approved antiandrogen agents apalutamide (Erleada) and enzalutamide (Xtandi), Concepcion says. The hypothesis among researchers was that this slight difference in molecular construct would give darolutamide an advantage in terms of central nervous system toxicity. At the 2019 Genitourinary Cancers Symposium, researchers reported that darolutamide not only delayed time to metastases versus placebo, but it also had a more favorable toxicity profile. This was specific to fatigue, which is significant under therapy with enzalutamide or apalutamide—somewhere on the order of 20% to 30%, Concepcion notes.