An up-to-date evaluation of darolutamide for the treatment of prostate cancer

ABSTRACT

Introduction: Currently, in prostate cancer, an increasing number of novel drugs are being used to delay its advancement to metastatic castration-resistant prostate cancer (mCRPC). Apalutamide, enzalutamide, and most recently, darolutamide (novel androgen receptor antagonists) have been approved for nonmetastatic castration-resistant prostate cancer (nmCRPC).

Areas covered: The authors have evaluated darolutamide, covering all aspects of the clinical development, competence, and safety profile of the drug.

Expert opinion: The unique structure of darolutamide is characterized by a high affinity for androgen receptors and detainment of antagonist activity in mutant isoforms of androgen receptors. In clinical practice, this is the main reason that makes darolutamide exceptional in terms of safety and efficacy compared to other drugs in this category. Darolutamide is considered to have the lowest probability for adverse events (AEs) compared to apalutamide and enzalutamide. Future studies, along with real-world clinical data are warranted to improve personalized treatment strategies as well as sequencing treatment between approved novel drugs.

KEYWORDS:

• Darolutamide
• enzalutamide
• apalutamide
• prostate cancer
• castration resistant
• metastatic
• non-metastatic

Article Highlights

• Novel agents have been approved for the treatment of non metastatic castration resistant prostate cancer

• Darolutamide is the most recent androgen receptor antagonists approved. It has unique chemical structure with high affinity to the androgen receptor and detainment of antagonist activity for mutant isoforms

• Darolutamide has a favourable efficacy and safety profile with a low incidence of adverse effects

• Ongoing trials are evaluating Darolutamide in patients with metastatic castration resistant prostate cancer

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.