In season 4, episode 14 of Targeted Talks, Dr. Alicia Morgans discusses the findings of the DEAR study, which evaluated the real-world utilization of second-generation androgen receptor (AR) inhibitors in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC). The study compared the effectiveness of darolutamide, enzalutamide, and apalutamide in patients based in the United States.
According to the results presented at the American Society of Clinical Oncology Annual Meeting, darolutamide demonstrated better outcomes in terms of treatment discontinuation and progression to metastasis (DIS/MET) compared to enzalutamide and apalutamide. A smaller percentage of patients receiving darolutamide experienced DIS/MET events, and the time to DIS/MET was longer for patients treated with darolutamide.
Furthermore, the study showed lower rates of discontinuation and progression to metastatic castration-resistant prostate cancer (mCRPC) in patients treated with darolutamide compared to those treated with enzalutamide and apalutamide. These findings were formally analyzed using both unadjusted and adjusted analyses.
One important aspect highlighted by the study is that darolutamide has a low potential for crossing the blood-brain barrier, making it a specific AR inhibitor. This characteristic could have significant implications for patients with nmCRPC, as brain metastases are a common concern in this population.
Overall, the real-world data from the DEAR study suggest that darolutamide may be a valuable treatment option for patients with nonmetastatic castration-resistant prostate cancer. The study highlights the importance of comparative research to inform clinical decision-making and improve patient outcomes.
Reference:
George DJ, Khan N, Constantinovici N, et al. Real-world use of darolutamide, enzalutamide, and apalutamide for non-metastatic castration-resistant prostate cancer (DEAR). J Clin Oncol. 2023;41(suppl 6). doi: 10.1200/JCO.2023.41.6_suppl.332
