4.3 Review

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

Journal

JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
Volume 122, Issue 4, Pages 299-308

Publisher

ELSEVIER TAIWAN
DOI: 10.1016/j.jfma.2022.12.008

Keywords

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

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Darolutamide, a second-generation androgen receptor inhibitor, has been shown to improve metastasis-free survival and overall survival in men with non-metastatic castration-resistant prostate cancer. It has a unique chemical structure that potentially offers advantages in terms of efficacy and safety compared to other similar drugs. Indirect evidence suggests that darolutamide is preferred due to its good adverse event profile.
Darolutamide, a second-generation androgen receptor inhibitor (SGARI), has been shown to in-crease metastasis-free survival and overall survival among men with non-metastatic castra-tion-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. Copyright (c) 2023, Formosan Medical Association. Published by Elsevier Taiwan LLC.

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