Site Editor
Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Thursday, March 23, 2023
According to findings from the DEAR study, which were presented at the 2023 American Society of Clinical Oncology (ASCO) Genitourinary (GU) Cancers Symposium (Abstract 332), second-generation androgen receptor (AR) inhibitors may be the preferred treatment of patients with nonmetastatic castration-resistant prostate cancer. This is reportedly the first study to assess the real-world use and outcomes of all currently available AR inhibitors: darolutamide, enzalutamide, and apalutamide.
“This real-world study in the United States shows that, despite similar baseline characteristics, fewer patients with nonmetastatic castration-resistant prostate cancer treated with darolutamide had discontinued initial AR inhibitor treatment or experienced progression to metastasis versus enzalutamide and apalutamide, and the time to this event was longer in the darolutamide cohort,” said Daniel J. George, MD, of Duke University School of Medicine, Durham, North Carolina, and colleagues.
A total of 828 electronic medical records were assessed by researchers of patients with nonmetastatic castration-resistant prostate cancer. Patients were divided into three cohorts, based on treatment: 280 patients (42%) received enzalutamide, 276 patients (41%) received darolutamide, and 110 patients (17%) received apalutamide.
Treatment discontinuation or progression to metastatic disease occurred in 37% of patients treated with darolutamide, compared with 51% of those treated with enzalutamide and 51% of those given apalutamide. The median time to treatment discontinuation or progression to metastatic disease was not reached in the darolutamide group. In contrast, these events occurred at a median of 23.1 months in the enzalutamide group and 20.5 months in the apalutamide group.
The investigators proposed a possible explanation for the differences reported among the AR inhibitors. “These findings may be attributed to darolutamide being a structurally distinct AR inhibitor, with a low potential for blood-brain barrier penetration,” they stated.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
2023 ASCO GU Cancers Symposium
JNCCN Spotlights
