Exploring FDA-Approved Therapies for Nonmetastatic Castration-Resistant Prostate Cancer

A. Oliver Sartor, MD, professor of medicine, medical director, Tulane Cancer Center, C. E. and Bernadine Laborde Professor of Cancer Research, discusses the current treatment options for patients with nonmetastatic castration-resistant prostate cancer (CRPC) and what physicians should consider when selecting treatment for their patients.

Three agents are approved for the treatment of nonmetastatic CRPC, which include apalutamide (Erleada), enzalutamide (Xtandi), and darolutamide (Nubeqa). All 3 drugs were tested in clinical trials, which resulted in positive findings that the FDA based their approvals on, says Sartor.

Between these 3 agents, there are some differences in terms of toxicities. However, there are no head-to-head trials to compare these. Sartor recommends considering the cost of the therapy, as well as potential implications for subsequent therapies when selecting 1 of these 3 agents to treat patients with nonmetastatic CRPC. He says we don’t know how patients who have been previously treated with these agents should be treated, so further data and analysis are necessary.

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