Darolutamide for non-metastatic castration-resistant prostate cancer: Efficacy, safety, and clinical perspectives of use

Cheng-Kuang Yang; Tai-Lung Cha; Yen-Hwa Chang; Shu-Pin Huang; Jen-Tai Lin; Shian-Shiang Wang; Chao-Yuan Huang; See-Tong Pang

doi:10.1016/j.jfma.2022.12.008

Darolutamide for non-metastatic castration-resistant prostate cancer: Efficacy, safety, and clinical perspectives of use

J Formos Med Assoc. 2023 Apr;122(4):299-308. doi: 10.1016/j.jfma.2022.12.008. Epub 2023 Feb 14.

Authors

Cheng-Kuang Yang¹, Tai-Lung Cha², Yen-Hwa Chang³, Shu-Pin Huang⁴, Jen-Tai Lin⁵, Shian-Shiang Wang⁶, Chao-Yuan Huang⁷, See-Tong Pang⁸

Affiliations

¹ Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taiwan.
² Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taiwan.
³ Division of General Urology, Department of Urology, Taipei Veterans General Hospital, Taiwan; Department of Urology, National Yang-Ming University School of Medicine, Taiwan.
⁴ Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Taiwan.
⁶ Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taiwan; Institute of Medicine, Chung Shan Medical University, Taiwan; Department of Applied Chemistry, National Chi Nan University, Taiwan.
⁷ Department of Urology, National Taiwan University Hospital, Taiwan; College of Medicine, National Taiwan University, Taiwan. Electronic address: cyh540909@gmail.com.
⁸ Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taiwan; Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taiwan. Electronic address: jacobpang@cgmh.org.tw.

PMID: 36797129
DOI: 10.1016/j.jfma.2022.12.008

Abstract

Darolutamide, a second-generation androgen receptor inhibitor (SGARI), has been shown to increase metastasis-free survival and overall survival among men with non-metastatic castration-resistant prostate cancer (nmCRPC). Its unique chemical structure potentially provides efficacy and safety advantages over the SGARIs apalutamide and enzalutamide, which are also indicated for nmCRPC. Despite a lack of direct comparisons, the SGARIs appear to have similar efficacy, safety, and quality of life (QoL) results. Indirect evidence suggests that darolutamide is preferred for its good adverse event profile, an attribute valued by physicians, patients, and their caregivers for maintaining QoL. Darolutamide and others in its class are costly; access may be a challenge for many patients and may lead to modifications to guideline-recommended regimens.

Keywords: Apalutamide; Castration-resistant prostate cancer; Darolutamide; Enzalutamide; Second-generation androgen receptor inhibitor.

Publication types

Review

MeSH terms

Androgen Receptor Antagonists / adverse effects
Humans
Male
Prostatic Neoplasms, Castration-Resistant* / drug therapy
Prostatic Neoplasms, Castration-Resistant* / pathology
Quality of Life
Treatment Outcome

Substances

darolutamide
Androgen Receptor Antagonists